bluuebunny/crossref_metadata_2025 huggingface dataset:
Pensar geográficamente en la educación infantil: de la imaginación a la construcción social del espacio concebido
Authors: Canet Mahiques Sandra , Morales Hernández Antonio José , García Monteagudo Diego
Published: May 2020

La tradición constructivista relaciona la forma de comprender el espacio que tiene el alumnado con su desarrollo físico y psíquico en función de la edad. Pero este planteamiento no explica con suficiente claridad las causas por las que los niños de Educación Infantil son capaces de representar lugares donde nunca han estado o evidenciar relaciones territoriales de cierta complejidad. Por ello hemos abordado un estudio de casos con alumnado de cinco años donde mostramos indicios que permiten evidenciar que el uso de su imaginación en la construcción del espacio concebido puede potenciarse mediante experiencias y recursos didácticos tales como los proyectos de aula y los cuentos.
Potencialidades Geográficas de La Laguna de las Peonías (Venezuela) como museo natural para la enseñanza de la Geografía física
Authors: Labarca Ramón , Barreto Belmary , Bernal Jorge
Published: May 2020

Se propone utilizar las potencialidades geográficas del escenario de la Laguna de las Peonías como museo natural para la enseñanza de la Geografía Física. La metodología es descriptiva, proyectiva, bajo un diseño de campo, no experimental. Al diagnosticar los “Recursos didácticos”, más del 80% de los encuestados afirma que el docente no utiliza “recursos dirigidos y naturales” en la enseñanza. Respecto al “nivel de conocimiento”, existe debilidad en el dominio del mismo, más del 75% de los estudiantes no acertaron en los indicadores “presencia de albuferas”, “presencia de playas y dunas costeras” y “procesos de sedimentación” de la Laguna de las Peonías. Se diseñó una propuesta de museo natural basado en el escenario de la referida laguna, materializado en una visita guiada que contempla cinco (5) estaciones.
Testing the advantages and disadvantages of short- and long- read eukaryotic metagenomics using simulated reads
Authors: Pearman William S , Freed Nikki E , Silander Olin K
Published: May 2020

Background: The first step in understanding ecological community diversity and dynamics is quantifying community membership. An increasingly common method for doing so is through metagenomics. Because of the rapidly increasing popularity of this approach, a large number of computational tools and pipelines are available for analysing metagenomic data. However, the majority of these tools have been designed and benchmarked using highly accurate short read data (i.e. Illumina), with few studies benchmarking classification accuracy for long error-prone reads (PacBio or Oxford Nanopore). In addition, few tools have been benchmarked for non-microbial communities. Results: Here we compare simulated long reads from Oxford Nanopore and Pacific Biosciences with high accuracy Illumina read sets to systematically investigate the effects of sequence length and taxon type on classification accuracy for metagenomic data from both microbial and non-microbial communities. We show that very generally, classification accuracy is far lower for non-microbial communities, even at low taxonomic resolution (e.g. family rather than genus). We then show that for two popular taxonomic classifiers, long reads can significantly increase classification accuracy, and this is most pronounced for non-microbial communities.Conclusions: This work provides insight on the expected accuracy for metagenomic analyses for different taxonomic groups, and establishes the point at which read length becomes more important than error rate for assigning the correct taxon.
Neonatal Eye Screening for 203 Healthy Term Newborns Using a Wide-Field Digital Retinal Imaging System
Authors: Leong Kenneth Teow Kheng , Kassim Siti Nur Amira Abu , Sidhu Jasvinjeet Kaur , Zohari Zayani , Sivalingam Thivakar , Ramasamy Sunder , Khialdin Safinaz Mohd , Nordin Noraihan Mohd , Rahmat Jamalia
Published: May 2020

Purpose: This study aimed to determine the proportion and types of ocular abnormalities detected in healthy term newborns and also the risk factors associated with retinal haemorrhages.Method: This cross-sectional study comprised of 203 participants, all healthy term newborn infants in the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a six months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared with similar studies previously published in the literature.Results: Total ocular abnormalities were detected in 34% infants. The most common finding was retinal haemorrhage in 29.6% infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of newborns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1 minute increment in the duration of 2nd stage of labour. Conclusion: Universal eye screening for all newborns using a wide-field digital imaging system is possible, safe and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage. Although most resolve spontaneously, a longitudinal study is needed to study the long term effect of retinal haemorrhages in these infants.
Spatial-temporal mapping of hand, foot and mouth disease in relation to climate factors in Xinjiang, China from 2008 to 2016
Authors: xie ling , Huang Ruifang , Wang Hongwei , Xiao Zhengqing
Published: May 2020

[Objectives]: The study mainly aims to depict the epidemiological characteristics of hand, foot and mouth disease (HFMD) in Xinjiang, China and evaluate the effects of meteorological factors on the incidence of HFMD through spatiotemporal analysis. This study provides substantial evidence for HFMD control and prevention.[Methods]: With the data from the national surveillance data of HFMD and meteorological parameters in the study area from 2008 to 2016. We first employed GeoDetector Model to examine the effects of meteorological factors on HFMD incidence in Xinjiang, China and to test the spatial-temporal heterogeneity of HFMD risk, and then the spatial autocorrelation was applied to examine the temporal-spatial pattern of HFMD.[Results]: From 2008 to 2016, the HFMD distribution showed a distinct seasonal pattern and HFMD cases typically occurred between May and July, peaking in June, in Xinjiang. The relative humidity, precipitation, air pressure and temperature had more influence than other risk factors on HFMD incidence with explanatory powers of 0.30, 0.29, 0.29 and 021(p<0.000), respectively. The interactive effect of any two risk factors would enhance the risk of HFMD and there was a nonlinear enhancement between any two risk factors interactive effect. The spatial relative risks in Northern Xinjiang were higher than in Southern Xinjiang. Global spatial autocorrelation analysis indicated the spatial dependency on the incidence of HFMD in 2008, 2010, 2012, 2014 and 2015. The spatial dependency was the negative spatial autocorrelation in 2009. The incidence of HFMD in Xinjiang presented a random distribution pattern in 2011 and 2016.[Conclusion]: Our findings show that the risk of HFMD in Xinjiang showed signiﬁcant spatiotemporal heterogeneity. The monthly average relative humidity, monthly average precipitation, monthly average air pressure and monthly average temperature factors might have stronger effects on the HFMD incidence in Xinjiang, China, compared with other factors. The distribution of HFMD in Xinjiang is different from other temperate continental climate zones due to the large difference in climate and latitude between Southern and Northern Xinjiang and their arid and semi-arid geographical environment. These associations draw attention to climate-related health issues and will help in establishing accurate spatiotemporal prevention of HFMD in Xinjiang, China.
Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study
Authors: Cao Jun , Gao Xiaoyun , Zhang Xiaoli , Li Jing , Zhang Junfeng
Published: May 2020

Background: Laryngeal mask airway (LMA) anesthesia with nerve block seems a promising alternative to traditional general anesthesia with endotracheal intubation (ETI), and was applied in kinds of surgeries but not in rib fracture surgery. We developed a protocol for LMA anesthesia technique and evaluated its feasibility for internal fixation of rib fractures. Methods: Twenty patients undergoing unilateral rib fracture surgery were enrolled. Thoracic paravertebral block(TPB) and/or erector spinae plane block(ESPB) were performed before LMA anesthesia. Heart rate (HR), blood pressure (BP), pulse oximetry (SpO 2 ) and respiratory parameters were measured. Arterial blood gas analysis and chest X-ray were performed preoperatively and on the day after the operation. All patients received postoperative continuous analgesia (PCA) with 500mg of tramadol and 16mg of lornoxicam, and intravenous 50mg flurbiprofen twice a day. The numerical rating scale (NRS) pain score at 6(T1), 12(T2), 24(T3) hours after surgery and postoperative nausea and vomiting(PONV) within 48 h after surgery were assessed as well. We also recorded the incidence of perioperative reflux, aspiration, and nerve block related complications. Results: Thirteen men and 7 women (age 35-70 years) were enrolled. Six (30%) had a flail chest, 9 (45%) had haemothorax and/or pneumothorax, and 2 (10%) had pulmonary contusions. Vital signs and spontaneous breathing were stable during the surgery. End-tidal carbon dioxide concentrations(EtCO 2 ) were within an acceptable range (≤ 63mmHg in all cases). The postoperative partial pressure of arterial oxygen (PaO 2 ) was higher than the preoperative value (91.2±16.0 vs. 83.7±15.9 mmHg, p =0.004). The preoperative and postoperative partial pressure of arterial carbon dioxide(PaCO 2 ) were 42.1±3.7 and 43.2±3.7mmHg ( p =0.165), respectively. NRS at T1, T2, and T3 were 3±1, 2±2, and 0, respectively. None suffered from PONV, regurgitation, aspiration and nerve block related complications. Conclusions: The technique of laryngeal mask anesthesia combined with nerve block was feasible for internal fixation of rib fractures.
Protective Role Of Glutathione And Role Of Nitric Oxide Production In The Pathogenesis Of Pterygium 
Authors: Parra Fidelina , Kormanovski Alexandre , Guevara-Balcazar Gustavo , Castillo-Hernández Maria del Carmen , Franco-Vadillo Antonio , Toledo-Blas Mireille , Jarillo-Luna Rosa Adriana , Lara-Padilla Eleazar
Published: May 2020

Background: In the pathogenesis of pterygium, the protective role of glutathione and nitric oxide production is unclear. These are important factors for homeostasis in the redox state of cells. The aim of this study was to determine the levels of these and related parameters in pterygium tissue. Methods: Five groups of tissue samples were examined: control, primary pterygium, recurrent pterygium and two groups of primary pterygium given a one-month NAC pre-surgery treatment (topical or systemic). The levels of endothelial nitric oxide synthase (e-NOS), nitric oxide (NO), 3-nitrotyrosine (3NT), reduced and oxidized glutathione (GSH and GSSG), and catalase (CAT) were evaluated in tissue homogenates. Results: Compared to the control, decreased levels of eNOS, NO and 3-nitrotyrosine as well as the degree of oxidation of GSH (GSSG%) were observed in primary and recurrent pterygium. 3-Nitrotyrosine and GSSG% were also reduced in the other pterygium groups. GSH and CAT were enhanced in recurrent pterygium and systemic-treated, but were unchanged for topical-treated primary pterygium. There was a strong positive correlation of eNOS with NO and 3NT, GSSG% with NO and 3NT, and GSH with GSSG and CAT. Conclusions: The results are congruent with the following proposed sequence of events leading to a protective response of the organism during the pathogenesis of primary pterygium: a decreased level of eNOS provokes a decline in the level of NO in pterygium tissue, which then leads to the modulation of the intracellular level of GSH through synthesis and/or mobilization from other tissues.
Dental Expenditure, Progressivity and Horizontal Inequality in Chinese Adults：Based on the 4th National Oral Health Epidemiology Survey
Authors: CHENG MengLin , WANG ChunXiao , WANG Xing , FENG XiPing , TAI BaoJun , HU DeYu , LIN HuanCai , WANG Bo , ZHENG ShuGuo , LIU XueNan , RONG WenSheng , WANG WeiJian , Si Yan , Xu Tao
Published: May 2020

Background: The financial burden of oral diseases is a growing concern as the medical expenses rise worldwide. The aim of this study was to investigate the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of the inequality for Chinese adults. Methods: A secondary analysis used the data of 13,464 adults from the 4 th National Oral Health Epidemiological Survey (NOHES) in China was undertaken. The dental expenditure was collected and divided into out-of-pocket and health insurance payments. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. The decomposition model of the concentration index was set up to explore the associated socioeconomic determinants. Results: The results showed that a mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval-CI: 18.83,22.26). Among those who actually used dental service, the cost was $100.95 (95%CI: 93.22,108.68). Over 90% of dental spending was due to out-of-pocket expenses. For self-reported oral health, the horizontal inequality index was -0.1391 and for the decayed tooth (DT), it was -0.2252. For out-of-pocket payment, the Kakwani index was -0.3154 and for health insurance payment it was -0.1598. Income, residential location, educational attainment, oral hygiene practice, self-reported oral health, age difference were the main contributors to the inequality of dental expenditure. Conclusion: Dental expenditure for Chinese adults was at a lower level due to underutilization. The ratio of payments of dental expenditure and utilization was disproportional, whether it was out-of-pocket or insurance payment. Individuals who were more in need of oral care showed less demand for service or not required service in time. For future policy making on oral health, it is worth the effort to further promote the awareness of the importance of oral health and utilization of dental service.
Rapid Detection of Babesia motasi Responsible for Human Babesiosis by Cross-priming Amplification Combined with a Vertical Flow
Authors: Wang Jinming , Gao Shandian , Zhang Shangdi , He Xin , Liu Junlong , Liu Aihong , Li Youquan , Liu Guangyuan , Luo Jianxun , Guan Guiquan , Yin Hong
Published: May 2020

Background: Babesia motasi is known as an etiological agent of human and ovine babesiosis. Diagnosis of babesiosis is traditionally performed by microscopy, examining Giemsa-stained thin peripheral blood smears. Rapid detection and accurate identification of species are desirable for clinical care and epidemiological studies. Methods: An easy to operate molecular method, which requires less capital equipment and incorporates cross priming amplification combined with a vertical flow (CPA-VF) visualization strip for rapid detection and identification of B. motasi. Results: The CPA-VF targets the 18S rRNA gene and has a detection limit of 50 fg per reaction; no cross reaction was observed with other piroplasms infective to sheep or Babesia infective to humans. CPA-VF and real-time (RT)-PCR had sensitivities of 95.2% (95% confidence interval [CI], 78.1-99.4%) and 90.5% (72-97.6%) and specificities of 95.8 (80.5-99.5%) and 97.9 (83.5-99.9%), respectively, versus microscopy and nested (n) PCR combined with gene sequencing. The clinical performance of the CPA-VF assay was evaluated with field blood samples from sheep (n = 340) in Jintai county, Gansu Province, and clinical specimens (n = 492) obtained from patients bitten by ticks. Conclusions: Our results indicate that the CPA-VF is a rapid, accurate, nearly instrument-free molecular diagnostic approach for identification of B. motasi. Therefore, it could be an alternative technique for epidemiological investigations and diagnoses of ovine and/or human babesiosis caused by B. motasi, especially in resource-limited regions.
Association of Depression and Resilience with Fertility Quality of Life among patients presenting to the infertility Centre for treatment in Karachi, Pakistan
Authors: Bhamani Shireen Shehzad , Zahid Nida , Zahid Wajeeha , Farooq Salima , Sachwani Saima , Chapman Marilyn , Asad Nargis
Published: May 2020

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. Thus, the aim of this study was: 1. To compare the QoL of males and females presenting at an infertility centre for treatment, 2. To assess the association of QoL with resilience, depression, and other socio-demographic factors in males and females presenting at an infertility clinic for treatment. Methods: An Analytical Cross-Sectional study was conducted and the study participants were recruited from the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. Results: After adjusting for the covariates we observed that the males who were less resilient their QoL was 8.47 units significantly lower and those who were depressed their QoL was 17.849 units significantly lower as compared to those who were more resilient and less depressed. Moreover, formal education, low monthly income, and friends were significantly associated with QoL among males . On the other hand, females who were less resilient their QoL was 8.606 units lower and those who were depressed their QoL was 19.387 units significantly lower as compared to those who were more resilient and less depressed. Additionally, formal education and low monthly income had a significant association with QoL among females. Conclusion: Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems.
Impact of intracellular toxic advanced glycation end-products (TAGE) on murine myoblast cell death: A non-clinical study
Authors: Takata Takanobu , Sakasai-Sakai Akiko , Takeuchi Masayoshi
Published: May 2020

Background: Sarcopenia is a progressive condition that is characterized by decreases in skeletal muscle mass and function. Although previous studies reported that sarcopenia is associated with non-alcoholic steatohepatitis (NASH), the underlying mechanisms remain unclear. We herein focused on glyceraldehyde, an intermediate of glucose/fructose metabolism. We previously designated glyceraldehyde-derived advanced glycation end-products (AGEs) as toxic AGEs (TAGE) because of their cytotoxicity and involvement in lifestyle-related diseases, such as NASH. We hypothesized that TAGE is associated with sarcopenia. Methods: C2C12 cells, which are murine myoblasts, were treated with 0, 0.5, 1, 1.5, and 2 mM glyceraldehyde for 24 h. Cell viability and intracellular TAGE were then assessed using 5-[2,4,-Bis(sodioxysulfonyl)phenyl]-3-(2-methoxy-4-nitrophenyl)-2-(4-nitrophenyl)-2H-tetrazole-3-ium (WST-8) and slot blot assays. Cells were pretreated with 8 mM aminoguanidine , an inhibitor of AGE production, for 2 h followed by 0, 1.5, and 2 mM glyceraldehyde for 24 h. Cell viability and intracellular TAGE were then assessed. Serum TAGE levels in STAM mice, in which there were four stages (no steatosis, simple steatosis, steatohepatitis, and fibrosis), were measured using an enzyme-linked immunosorbent assay. Results were expressed as TAGE units (U) per milliliter of serum, with 1 U corresponding to 1.0 μg of glyceraldehyde-derived AGE-bovine serum albumin (BSA) (TAGE-BSA). The viability of cells treated with 20, 50, and 100 μg/mL non-glycated BSA and TAGE-BSA for 24 h was assessed using the WST-8 assay. Results: In C2C12 cells treated with 1.5 and 2 mM glyceraldehyde, cell viability decreased to 47.7% ( p =0.0021) and 5.0% ( p =0.0001) and intracellular TAGE levels increased to 6.0 and 15.9 μg/mg protein, respectively. Changes in cell viability and TAGE production were completely inhibited by 8 mM aminoguanidine. Serum TAGE levels at the steatohepatitis and fibrosis stages were 10.51 ±1.16 and 10.44±0.95 U/mL, respectively, and were higher than that at the no steatosis stage (7.27±0.18 U/mL). Cell death was not induced by 20 or 50 μg/mL TAGE-BSA. The viabilities of C2C12 cells treated with 100 μg/mL non-glycated BSA and TAGE-BSA were 105.0% ( p =0.2890) and 85.3% ( p =0.0217), respectively. Conclusion: Intracellular TAGE strongly induce myoblast cell death and may cause sarcopenia. Therefore, TAGE may play a crucial role in sarcopenia associated with NASH .
Genetic diversity and genotype multiplicity of Plasmodium falciparum infection in patients with uncomplicated malaria in Chewaka district, Ethiopia
Authors: Abamecha Abdulhakim , El-Abid Hassan , Yilma Daniel , Addisu Wondimagegn , Ibenthal Achim , Bayih Abebe Genetu , Noedl Harald , Yewhalaw Delenasaw , Moumni Mohieddine , Abdissa Alemseged
Published: May 2020

Background: Genetic diversity in Plasmodium falciparum poses a major threat to malaria control and elimination interventions. Characterization of the genetic diversity of Plasmodium falciparum strains can be used to assess intensity of parasite transmission and identify potential deficiencies in malaria control programmes, which provides vital information to evaluating malaria elimination efforts. In this study, we investigated the P. falciparum genetic diversity and genotype multiplicity of infection in parasite isolates from cases with uncomplicated P. falciparum malaria in Southwest Ethiopia.Methods: A total of 80 P. falciparum microscopy and qPCR positive blood samples were collected from study participants aged six months to sixty years, who visited the health facilities during study evaluating the efficacy of arthemeter-lumefantrine from September-December, 2017. Polymorphic regions of the msp-1 and msp-2 were genotyped by nested polymerase chain reactions (nPCR) followed by gel electrophoresis for fragment analysis.Results: Of 80 qPCR-positive samples analyzed for polymorphisms on msp-1 and msp-2 genes, the efficiency of msp-1 and msp-2 gene amplification reactions with family-specific primers were 95 % and 98.8%, respectively. Allelic variation of 90% (72/80) for msp-1 and 86.2% (69/80) for msp-2 were observed. K1 was the predominant msp-1 allelic family detected in 20.8% (15/72) of the samples followed by MAD20 and RO33. Within msp-2, allelic family FC27 showed a higher frequency (26.1%) compared to IC/3D7 (15.9%). Ten different alleles were observed in msp-1 with 6 alleles for K1, 3 alleles for MAD20 and 1 allele for RO33. In msp-2, 19 individual alleles were detected with 10 alleles for FC27 and 9 alleles for 3D7. Eighty percent (80%) of isolates had multiple genotypes and the overall mean multiplicity of infection was 3.2 (95% CI: 2.87- 3.46). The heterozygosity indices were 0.43 and 0.85 for msp-1 and msp-2, respectively. There was no significant association between multiplicity of infection and age or parasite density.Conclusions: The study revealed high levels of genetic diversity and mixed-strain infections of P. falciparum populations in Chewaka district, Ethiopia, suggesting that both, endemicity level and malaria transmission remain high and that strengthened control efforts are needed in Ethiopia.
Who exercises for mood regulation? Results from the Guangdong National Physique Monitoring data
Authors: Li Tong , Lou Jingjing , Hu Ying , Zheng Xiabing , Zheng Liangrong , Zhu Qi , Yang Weirui , Zhang Yaqi , Guan Nianhong
Published: May 2020

Background: This study focused on different exercise motivations, especially mood regulation and their relation to the sociodemographic status, exercise pattern and physical conditions of adults and older adults in China who did not undergo interventions.Methods: A total of 5242 participants aged 20-69 years from 2016 to 2018 were recruited in this cross-sectional study to finish the questionnaire of Guangdong National Physique Monitoring organized by the Guangzhou Institute of Sports Science. Multiple statistical analyses methods were used to study each exercise motivation and its sociodemographic characteristics (gender, age, education and job), exercise measurements (frequency, duration and intensity) and physical conditions (BMI, abdominal obesity and basic diseases). An exercise index that is good for mental health (index 1: 45 min per session and 3-5 times per week; index 2: exercise motivation of mood regulation and exercise 60-120 min per week) was also used to investigate the number and type of people who were more likely to meet the index. Results: In our study, 44.9% (2355/5242) of participants showed exercise inactivity. No gender difference was observed among those who exercised for mood regulation. Only older participants and those with an average level of education showed a significant association with mood regulation. Few people met the index that is good for mental health (16.64% (872/5242) met index 1 and 2.84% (149/5242) met index 2), and higher education showed a significant association with a reduction in the mental health burden and the prevention of depression. Conclusion: This investigation suggests motivating people to be more active, educating people on the mental health benefits of exercise.
A process for developing a sustainable and scalable approach to community engagement: Community Dialogue Approach for addressing the drivers of antibiotic resistance in Bangladesh
Authors: King Rebecca , Hicks Joseph , Rassi Christian , Shafique Muhammad , Barua Deepa , Bhowmik Prashanta , Das Mahua , Elsey Helen , Questa Kate , Fieroze Fariza , Hamade Prudence , Huque Sameena , Newell James , Huque Rumana
Published: May 2020

Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example.Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level.Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable.Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.
Proteogenomic analysis of Inhibitor of Differentiation 4 (ID4) in basal-like breast cancer
Authors: Baker Laura A. , Holliday Holly , Roden Daniel , Krisp Christoph , Wu Sunny Z. , Junankar Simon , Serandour Aurelien A. , Mohammed Hisham , Nair Radhika , Sankaranarayanan Geetha , Law Andrew M.K. , McFarland Andrea , Simpson Peter T. , Lakhani Sunil , Dodson Eoin , Selinger Christina , Anderson Lyndal , Samimi Goli , Hacker Neville F. , Lim Elgene , Ormandy Christopher J. , Naylor Matthew J. , Simpson Kaylene , Nikolic Iva , O’Toole Sandra , Kaplan Warren , Cowley Mark J. , Carroll Jason S. , Molloy Mark , Swarbrick Alexander
Published: May 2020

Background Basal-like breast cancer (BLBC) is a poorly characterised, heterogeneous disease. Patients are diagnosed with aggressive, high-grade tumours and often relapse with chemotherapy resistance. Detailed understanding of the molecular underpinnings of this disease is essential to the development of personalised therapeutic strategies. Inhibitor of Differentiation 4 (ID4) is a helix-loop-helix transcriptional regulator required for mammary gland development. ID4 is overexpressed in a subset of BLBC patients, associating with a stem-like poor prognosis phenotype, and is necessary for the growth of cell line models of BLBC, through unknown mechanisms. Methods Here, we have defined unique molecular insights into the function of ID4 in BLBC and the related disease high-grade serous ovarian cancer (HGSOC), by combining RIME proteomic analysis, ChIP-seq mapping of genomic binding sites and RNA-seq. Results These studies reveal novel interactions with DNA damage response proteins, in particular, mediator of DNA damage checkpoint protein 1 (MDC1). Through MDC1, ID4 interacts with other DNA repair proteins (γH2AX and BRCA1) at fragile chromatin sites. ID4 does not affect transcription at these sites, instead binding to chromatin following DNA damage. Analysis of clinical samples demonstrates that ID4 is amplified and overexpressed at a higher frequency in BRCA1 -mutant BLBC compared with sporadic BLBC, providing genetic evidence for an interaction between ID4 and DNA damage repair deficiency. Conclusions These data link the interactions of ID4 with MDC1 to DNA damage repair in the aetiology of BLBC and HGSOC.
Improving malaria preventive practices and pregnancy outcomes through a health educational intervention: a randomized controlled trial
Authors: BALAMI AHMED DAHIRU , Said Salmiah Muhammad , Zulkefli Nor Afiah Muhammad , Norsa’adah Bachok , AUDU BALA MUHAMMAD
Published: May 2020

Background: The prevalence of malaria in pregnancy and its complications, remain very high in Nigeria. This study aimed to determine the effects of a malaria health educational intervention based on the information-motivation-behavioural skills (IMB) model on malaria preventive practices and pregnancy outcomes. Methods: The study was a randomized controlled parallel-group study, where 372 randomly selected antenatal care attendees were randomly assigned to one of either two groups after collecting baseline data. The intervention group then received a four-hour health education intervention developed based on the IMB model, while the control group received a similarly designed health education on breastfeeding, and were then followed-up to the end of their pregnancies. The intention-to-treat analysis using the generalized linear mixed models was used to analyse the data obtained. Results: The reported frequency of ITN use and dose of IPTp taken, were higher in the intervention group by 0.32 levels (p=0.024) and 0.37 doses (p<0.001) respectively, implying that for 32% and 37% of the participants, an individual in the intervention group slept more frequently under an ITN by one day, and had also took one dose of IPTp more than an individual in the control group. The intervention group also achieved a haematocrit level of 0.80% higher than the control group. The intervention however, had no significant effect on the incidence of malaria diagnosis or babies’ birth weights. Conclusion: The intervention was effective in improving ITN use, IPTp uptake, and haematocrit levels. It is therefore recommended for the module to be adopted and incorporated into the routine antenatal care programmes in the state. Trial registration: Pan African Clinical Trial Registry, PACTR201610001823405. Registered 26 October 2016, www.pactr.org.
Exploring the Consequences of Teachers’ Self-efficacy: A Case of Teachers of English as a Foreign Language
Authors: Alibakhshi Goudarz , Nikdel Fariborz , Labafi Akram
Published: May 2020

Teacher self-efficacy, as a socio-affective concept, has been abundantly studied in relation to different factors. However, it seems that the consequences of teachers' self-efficacy have not been appropriately explored to the present date. The present study aimed at investigating the consequences of EFL teachers' teaching self-efficacy. In so doing, a qualitative research method was used. The data were collected through semi-structured interviews with 20 EFL teachers who were selected through purposive sampling. The interviews were content analyzed thematically. Findings showed that self-efficacy has three main consequences: pedagogical, learner-related, and psychological. Each of these consequences has several sub-categories. It can be concluded that high self-efficacy affects teachers’ teaching practices, learners’ motivation, and achievement. It also affects teachers’ burn-out status, psychological being, as well as their job satisfaction. The findings can be theoretically and pedagogically important to EFL teachers, teacher-trainers, and administrators of educational settings.
Generate-Boost: study protocol for a prospective, multicenter, randomized controlled, double-blinded phase II trial to evaluate efficacy and safety of bortezomib in patients with severe autoimmune encephalitis
Authors: Wickel Jonathan , Chung Ha-Yeun , Platzer Stephanie , Lehmann Thomas , Prüss Harald , Leypoldt Frank , Günther Albrecht , Scherag André , Geis Christian
Published: May 2020

Background: Autoimmune encephalitis is a new spectrum of autoimmune disorders of the central nervous system (CNS), which are characterized by pathogenic autoantibodies against neuronal surface antigens. Clinical presentations range from acute to subacute encephalopathy with neurological and psychiatric symptoms, and life-threatening autonomic dysfunction in severe cases. There exist no approved therapies nor is data available from controlled clinical trials. Patients are usually treated with diverse combinations of immunotherapy. However, effect of immunotherapy on antibody-producing cells and thus on levels of pathogenic autoantibodies is insufficient. Therefore, therapeutic response is sometimes prolonged with necessity of long-time intensive care treatment and also irreversible deficits occur in severe cases. This trial will investigate the efficacy and safety of bortezomib, a proteasome inhibitor known to selectively deplete plasma cells, in patients with severe autoimmune encephalitis who have been treated with rituximab with insufficient response.Methods: Generate-Boost is an investigator-initiated, multicenter, double-blinded, randomized controlled phase II trial which will be conducted in specialized neurological hospitals within the GENERATE (GErman NEtwork for Research on AuToimmune Encephalitis) network in Germany. Adult patients with severe autoimmune encephalitis (modified Rankin scale, mRS ≥ 3), autoantibodies against neuronal surface antigens, and pretreatment with rituximab are eligible for study participation. 50 patients will be randomized 1:1 and undergo up to 3 cycles (each 21 days with 4 s. c. applications) of bortezomib or placebo. All patients will receive concomitant medication with dexamethasone, acyclovir and co-trimoxazole. The primary efficacy endpoint is the mRS score 17 weeks after first treatment application. Secondary endpoints are neurocognitive function, antibody titers, markers of neuronal cell damage, length of ICU/hospital stay as well as mRS and Glasgow coma scale scores throughout the trial up to week 17. General and bortezomib-specific adverse events are monitored continuously. Discussion: The expected outcome of the study is to obtain first reliable data on a hypothesis-driven therapeutic option in severe and difficult-to-treat autoimmune encephalitis. If treatment with bortezomib is beneficial in these cases, this will be the basis for implementation in the current guidelines. Trial registration: Clinicaltrials.gov, NCT03993262. Registered June 20, 2019;https://www.clinicaltrials.gov/ct2/show/NCT03993262German Clinical Trials Register, DRKS00017497
A N-propionylsulfonamide prodrug of K-5a2 provided improved aqueous solubility and hERG inhibition
Authors: Zuo Xiaofang , Huo Zhipeng , Kang Dongwei , Zhao Tong , Clercq Erik De , Pannecouque Christophe , Chen Chin Ho , Lee Kuo-Hsiung , Liu Xinyong , Zhan Peng
Published: May 2020

Background Having the potential disadvantages and safety risk of the use of anti-HIV-1 drug candidate K-5a2 in the longterm treatment of HIV patients in mind, we set out with the goal of finding a second-generation backup compound of K-5a2 with the appropriate anti-HIV potency, significantly reduced hERG activity, decreased induction of the CYP enzyme, and improved aqueous solubility. Herein, using a N-propionylsulfonamide prodrug strategy, we report the discovery of compound HM-1Methods In vitro assay of anti-HIV activities in TZM-bl and MT-4 cells, metabolic stability in HLM and human plasma, measurements of water solubility and Log P, assay procedures for hERG activity, acute and subacute toxicity experiment and cytochrome P450 inhibition assay were carried out for HM-1.Results HM-1 can be rapidly hydrolyzed to parent drug K-5a2 and exhibited high potency against HIV-1NL4 − 3 strain (EC50 = 7.99 nM) in TZM-bl cells, HIV-1IIIB strain (EC50 = 2.9 nM) and HIV-1Y181C strain (EC50 = 5.5 nM) in MT-4 cells. And it also showed a > 70-fold improvement in aqueous solubility and presented a low acute toxicity in mice (LD50 > 2 g•kg− 1); no obvious organ damage was detected in the assessment of subacute toxicity. Meanwhile, HM-1 also showed 50 times lower hERG inhibition (IC50 = 6.39 µM) than K-5a2 (IC50 = 0.13 µM).Conclusions It was HM-1 appeared to be free of most of the drawbacks associated with K-5a2 and has been selected for further development as an oral anti-HIV-infection agent.
Moxibustion versus diclofenac sodium gel for the treatment of knee osteoarthritis: a double-blinded, double-placebo, randomized controlled trial
Authors: Luo Ling , Liao Mo , Zhou Jian-Ying , Peng Jia-Xi , Wang Xiang , Zhang Cai-Rong , Guo Ling-Ling , Liu Min , Wang Jia-Ping , Han Xiao-Xia , Lu Sheng-Feng , Hou Tian-Shu , Du Ping , Zhao Jing-Jing , Zuo Jia , Chen Jing-Zhu , Huang Bi-Qing , Peng Jia , Ran Guo-Ping , Zhu Lin-Lin , Yin Hai-Yan , Wu Qiao-Feng , Zhang Cheng-Shun , Lv Peng , Tang Yong , Yu Shu-Guang
Published: May 2020

ObjectiveThe purpose of this study was to evaluate the difference of efficacy between moxibustion (experimental group) and local diclofenac sodium gel (control group) in the treatment of knee osteoarthritis (KOA).MethodsA multicenter, double-blinded, double-placebo, randomized controlled clinical trial was conducted in this research. 144 participants with knee osteoarthritis were randomly divided into two groups according to 1:1 ratio. The participants in the experimental group were treated with active Moxibustion plus placebo gel, whereas the control group was given diclofenac sodium gel plus placebo moxibustion. Moxibustion treatment was administrated at 3 acupoints (EX-LE4, ST35, ST36) for 4 weeks in 12 sessions. The entire trial cycle lasted 13 weeks, including 1 week at baseline, 4 weeks at treatment and 8 weeks at follow-up. Diclofenac sodium gel or placebo gel at a dose of 4 g per knee were applied three times per day for 4 weeks. The primary outcome measures were the changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcome measures included changes in other subscales of WOMAC (pain, stiffness and function), visual analogue scale (VAS) and participant overall assessment (PGA).ResultsThe analysis showed that both the experimental group and the control group at 2 weeks, 4weeks, 8weeks and 12 weeks were statistically significant compared with baseline (P <0.05). There was no significant difference between the two groups in the first four weeks (P > 0.05). At 8 weeks, WOMAC total score (95% CI, 4.3 [0.5 to 8.1], P=0.03), pain score (95% CI, 1.0 [0.2 to 1.9], P=0.02) and functional score (95% CI, 3.0 [0.1 to 5.8], P=0.04) the control group are better than the experimental group (P < 0.05). At 12 weeks, there were no significant difference between the two groups (P > 0.05). ConclusionsDuring the treatment, moxibustion has the same therapeutic effect as local diclofenac sodium gel, which can alleviate the pain of KOA participants to different degrees, rigidity and dysfunction. The therapeutic effect of it can basically maintained until 2 months after treatment. Local diclofenac sodium gel was superior to moxibustion in relieving knee pain and knee dysfunction at 8 weeks.Trial registration number Clinical Trials.gov, NCT02769572.Date of trial registration May 2016＃These authors contributed equally to this work.
Adverse birth outcomes among women who gave births at Eastern Ethiopian Hospitals: a cross sectional study
Authors: Dibisa Teshale Mulatu , Kebede Adera Debela , Gelano Tilaye Feto , Bacha Yadeta Dessie , Jemal Kemal
Published: May 2020

Background

Adverse births outcomes (ABO) such as preterm birth, low birth weight (LBW) and stillbirth are important determining of neonatal morbidity and mortality. It is the major public health problem in low resourced countries. Despite many efforts to reduce neonatal morbidity and mortality, adverse birth outcomes in hospitals has remained high. Therefore, this study aimed to assess the prevalence and factors associated with adverse birth outcomes among women who gave birth at selected public hospitals in Eastern Ethiopia.
Methods

Facility based cross-sectional study design was conducted in February 2017. Data were collected using a pretested and structured face to face interviewer-administered questionnaire. Binary logistic regression was used to analyze the association between the dependent and independent variables.
Results

A total of 555 women who give births were involved from four hospitals in Eastern Ethiopia. The prevalence of low birth weight, stillbirth and preterm births were 40(7.2%), 37(6.7%) and 28(5%) respectively. The overall prevalence of adverse birth outcomes was 76(13.7%). Four-ninth 247(44.5%) of mothers had high-risk pregnancies. Hypertension [AOR = 7.25; 95%, CI= (1.71, 30.64)], history of adverse birth outcome [AOR = 12.12; 95%, CI= (6.5, 22.6)], multiple pregnancy [AOR = 6.94; 95%, CI= (2.74, 17.53)] and spontaneous vaginal delivery [AOR = 0.11; 95%, CI= (0.44, 0.16)] were associated with adverse birth outcome.
Conclusion

In this study adverse birth outcomes were still found as public health problems. Hypertension, history of adverse birth outcome, multiple pregnancy and spontaneous vaginal delivery were significantly associated with ABO. Thus, developing strategies to prevent and treat complications during pregnancy and increasing maternal health utilization at ANC clinics are warranted.
Exploring anti-nonalcoholic fatty liver disease mechanism of Gardeniae Fructus by combining an animal model with network pharmacology and molecular docking
Authors: Li Lin , Lu Lihua , Tang Zhong-yan , Xia Zhengxiang
Published: May 2020

Background

Gardeniae Fructus (GF), a traditional Chinese medicine in clinic for the treatment of nonalcoholic fatty liver disease (NAFLD). However, the mechanisms of action of GF was still margin. To explore the efficacy and mechanism of action of GF for the treatment of NAFLD, we proposed a strategy combined in vivo efficacy verification, network pharmacology analysis, molecular docking, and validity assay of target protein.
Methods

Firstly, an animal model induced by the high fat diet feed was established, then orally administrated with GF, the mRNA expression levels of lipogenesis was performed by RT-PCR, the liver tissue specimens were stained by hematoxylin and eosin (H&E), then observed by light microscopy. Secondly, network pharmacology studies clarified the relationship among the active constituents, target protein, and pathways, and then explored by the molecular docking. Finally, validity assay of target protein was performed in surface plasmon resonance (SPR) test.
Results

GF protected against NAFLD in rats. Network pharmacology showed that quercetin, oleanolic acid, and geniposide, targeted on PPARα, PPARγ, and CA2 genes, through regulating PPAR, AMPK, and cGMP-PKG signal pathways, to protect against NAFLD. And the
Conclusion

GF could alleviate NAFLD through the molecular mechanisms explored by network pharmacology, molecular docking, and surface plasmon resonance, those method can be effective tools to clarify the mechanisms of actions of traditional Chinese medicine from a holistic perspective.
Assessment of changes in blood urea and creatinine levels in patients with coronavirus disease 2019 (COVID-19)
Authors: Mahmoudi Hassan , Alikhani Mohammad Yousef , Taheri Narges Mofrad , Behzadi Alireza
Published: May 2020

Background Coronavirus disease 2019 (COVID-19) is new respiratory tract infections disease with an evolving understanding of its epidemiology and clinical appearances. Kidney defect seems to be common in patients with Covid-19. Urea and creatinine level often occurs at the beginning or during the infection. This evidence shows that Covid-19 also attacks the kidneys. The aim of this study was to evaluate changes in biochemical parameters associated with kidney function, including urea and creatinine in patients with COVID-19.Methods We conducted a retrospective analysis of the plasma creatinine and urea levels of the 100 COVID-19 patients with normal plasma creatinine and urea at first clinical presentation of COVID-19.Results Among these 100 patients with COVID 19, total of 35 (35%) patients, increased BUN and creatinine levels occurred at duration of 2–4 days after the onset of viral infection. The mean serum urea level in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 34.75 ± 0.10 and 37.64 ± 0.32, 39.81 ± 0.10, 42.56 ± 0.35 mg/dl, respectively. The mean of creatinine concentration in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 1.50 ± 0.026 and 1.51 ± 0.016, 1.99 ± 0.012, 2.58 ± 0.020 mg/dl, respectively.