bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Glucocorticoid Receptors in the Early Period After the Return of Spontaneous Circulation Among Patients Who Experienced Cardiac Arrest : A Retrospective Observational Study
Authors: Yu Yanan , Tang Ziren , Li Jiabao , Xie Miaorong , Hang Chenchen , An Le , Li Chunsheng
Published: March 2021

Background: Rapid changes in glucocorticoid (GC) levels and adrenal insufficiency are related to the development of post-cardiac arrest syndrome. However, changes in glucocorticoid receptors (GR) have not been studied. Hence, this study aimed to investigate the association of early changes in GR and prognosis and immune response in patients who experienced cardiac arrest (CA). Methods: In this observational single-center case-control study, we enrolled patients who were in the early period of return of spontaneous circulation after CA and were admitted to the emergency department of the Beijing Chaoyang Hospital between October 2018 and October 2019. Age- and sex-matched healthy individuals were recruited for the control group after a physical examination.GR expression and cell counts of circulatory T and B lymphocytes, natural killer, and regulatory T (Treg) cells were assessed. Plasma total cortisol and adrenocorticotrophic hormone (ACTH) levels were tested. Since the data for total cortisol and ACTH levels had a skewed distribution, we compared our results with the natural logarithmic conversion values after adding 1 (ln [total cortisol+ 1], ln [ACTH+ 1]). Measurement data with a skewed distribution are expressed as medians (25th and 75th percentiles). The Mann–Whitney U test was used to compare variables between groups. The qualitative parameters in the 2 × 2 contingency table were used for analysis.Results: Overall, 85 patients who experienced CA and 40 healthy individuals were enrolled. All cell counts were lower and plasma total cortisol levels were higher (P<0.001) in patients who experienced CA than those in the healthy control group. GR expression in Treg cells and CD3+CD4+ T lymphocytes was not significantly different, but the mean fluorescence intensity and GR expression in other cells were lower in patients who experienced CA (P<0.05) than those in the healthy control group. ACTH levels did not show any difference. There were no significant differences between survivors and non-survivors. Conclusion: Our findings provide insights into GC sensitivity and immunosuppressive status in these patients, and a new perspective for GC targeted treatment.
Effectiveness of Single Dose Premedication of Piroxicam and Prednisolone on Post Endodontic Pain in One Visit Root Canal Treatment: A Randomized Trial
Authors: TANWIR ANUM , AHMED SHAHBAZ , AKHTAR HIRA , WAHID UMAIR , SHAKOOR MARIA , SHAHNAWAZ DANISH
Published: March 2021

BACKGROUNDMany approaches have been investigated for pain relief after root canal procedure. In this study we compare the effectiveness of premedication drugs, given single dose Piroxicam and Prednisolone separately to evaluate post endodontic pain at different time intervals (24, 48, 72 and 96 hours) using visual analog scale (VAS) after single visit root canal treatment.METHODSTotal number of 120 patients identified with symptomatic irreversible pulpitis were made part of this research after signing informed consent. The pain intensity levels were marked through the use of VAS scale before the commencement of treatment. The participants were randomly placed in three groups (n=40) Group I: Control, Group II: Piroxicam (20 mg) and Group III: Prednisolone (20 mg). The drugs were administered thirty minutes before endodontic procedure was initiated. Root canal procedure was carried out followed by placement of provisional restoration on a single appointment. The patients were advised to continue marking their pain intensity levels after 24, 48, 72 and 96 hours using VAS. All patients were called for follow up after 4 days for clinical evaluation and placement of permanent restoration. The effectiveness of each drug over different time interval was studied employing repeated measure ANOVA. The significance level was considered p-value <0.05.RESULTSAdministration of pre-medication drug therapy with Piroxicam and Prednisolone was able to successfully alleviate post-endodontic pain. However, the long term effectiveness (96 hours) of both drugs to reduce post-endodontic pain was observed to be statistically insignificant.CONCLUSIONPre-medication with either single dose Piroxicam and Prednisolone was found to be effective against post-endodontic pain, in patients presenting with symptomatic irreversible pulpitis.TRIAL REGISTRATION: This single blinded, randomized clinical trial [registration no. NCT04124822(11/10/2019)] was performed in Operative Dentistry department of Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences.
Association Between Social Capital and Performance Among Core Members of Chinese Ngos in Aids Prevention and Control: A Cross-sectional Study
Authors: Sang Lingzhi , Liu Meng , Xu Xiaoru , Bai Zhongliang , Zhang Xingxi , Wang Danni , Chen Ren
Published: March 2021

Background The role of non-governmental organizations in the field of AIDS prevention and control is increasingly being valued in China and even the world.This research aimed to study the status of social capital and performance of core members of non-governmental organizations (NGOs), as well as the relation between the two, in the field of HIV/AIDS prevention and control in China. Methods We used a multi-stage stratified cluster random sampling method to conduct a survey among 327 core members of 212 NGOs in the field of HIV prevention and control in eight provinces in China from July to December 2015. The questionnaire included items on demographic characteristics of core members, a social capital scale, and an organizational performance scale. We analyzed the data using chi-squared test and logistic regression.Results From the perspective of social capital, the core personnel of NGOs with extensive social networks and high levels of social support accounted for a relatively low proportion of the total sample, at 29.1% (95 people) and 36.7% (120 people), respectively. The chi-squared test results indicated the statistical significance of differences in factors such as educational background of the core personnel. The logistic regression analysis results indicated that trust in social capital was positively correlated with structural performance (OR = 2.21, 95% CI: 1.24–3.95). Social support, cohesion, and sense of belonging were correlated to the level of personal authority in performance evaluation (OR = 2.78, 95% CI: 1.43–5.39). The results also showed no statistically significant correlation between social network in social capital and performance level.Conclusions Improvement in social capital can promote better organizational performance. For the core members of NGOs, improvement in the level of social capital and performance was conducive to playing an active role in HIV/AIDS prevention and control. Our results can provide insights for decision-making and guiding the activities of NGOs engaged in HIV/AIDS prevention and control services.
Effect of postpartum experience and infant temperament on maternal beliefs about infant crying
Authors: Hiraoka Daiki , Nomura Michio , Kato Masaharu
Published: March 2021

Infant crying is an important signal for their survival and socio-cognitive development. It is unclear how maternal beliefs about infant crying change with their caregiving experience. Additionally, this study examined a bidirectional relationship between maternal beliefs and infants’ temperament using longitudinal study design. Maternal beliefs about crying and infant temperament of first-time mothers were measured at 1-month intervals over a 4-month period (N = 339 at Wave 1 and N = 164 at Wave 4). We found that parent-oriented beliefs about crying increased with the mother’s experience, and that infants high on surgency predicted changes in maternal beliefs. The current results suggest that the maternal beliefs change with an infant’s development and parenting experience in the early postpartum period.
Pattern and Distribution of Human Brucellosis Diagnosed in the National Animal and Plant Health Laboratory of Eritrea
Authors: Ghebrenegus Amon Solomon , Mengesha Soliana Binega , Abdulkadir Munir Wehab , Weldeyesus Mussie , Tewelde Asmerom Tesfagiorgis , Ghebrenegus Azariel Solomon
Published: March 2021

Background: Currently, brucellosis is the most widespread zoonotic disease in the world. In Eritrea, the disease has been documented since the 1940s, with widespread infections throughout the country.That being said, the only facility that tested for brucellosis is the National Animal and Plant Health Laboratory of Eritrea (NAPHL). Therefore, this study will focus on the pattern and distribution of human brucellosis tested and diagnosed at NAPHL. Method: This study is a retrospective cross-sectional look at all the Rose-Bengal test confirmed Brucellosis cases at the NAPHL from January, 2017 to December, 2019. Results:A total of 848 cases were detected out of 2,669 patients tested. The male to female ratio was 2.78 in those who tested positive for brucellosis. In the years, 2018 and 2019, the age range was between 1 and 89 with a mean of 29 years. Patients came from 5 of the 6 zones of Eritrea. Across the study period, no tests were recorded from the Southern Red Sea zone. Overall, Maekel Zone had the most cases, followed by Debub Zone and Northern Red Sea Zone.Scatter plot imaging by village showed a dense scatter area around the Maekel zone. Cases mapping by sub-zone showed highest number of cases in the Sub-Zones of the Maekel Zone and those located closest to the zone (namely Ghindae, Segheneiti, Dubarwa and Dekemhare). Conclusion:As human brucellosis is widespread in Eritrea,the government should take quick actions to increase accessibility to testing and treatment facilities,and implement an eradication program.
WITHDRAWN: Identification, Molecular Profiling, Docking Studies and determination of In-vivo Anti-Inflammatory Potential of Teucrium Stocksianum Bioss Fixed Oil (FO)
Authors: Shah Syed Muhammad Mukarram , Shah Syed Muhammad Hassan , Zafar Rehman , Khan Mohammad Ijaz , Hussain Fida , Zeb Anwar , Shah Syed Wadood Ali , Jan Muhammad Saeed
Published: March 2021

Background: Considering the positive and valuable upshots of the naturally occurring ingredients as the complementary treatment for many ailments, this study investigates the Teucrium Stocksianum Bioss Fixed Oil (FO) for the treatment of inflammation.Methods: Different plants of the Teucrium genera have been employed occasionally for the management of different disorders. Teucrium stocksianum (Lamiaceae) is traditionally use as antipyretic along with remedy of inflammation, diabetes and tumors. It also occupies the capacity to purify the blood. The aim of this study is to determine the chemical constituents and anti-inflammatory potentials of Teucrium stocksianum fixed oil (FO). Qualitative and quantitative analysis of fixed oil were performed via GC-MS (Gas Chromatography coupled with Mass Spectrometer). Preliminary inflammation antagonistic activity was calculated in mice using the carrageenan-induced paw edema model while the mechanism behind this inflammatory antagonistic effect was determined by employing various inflammogens including arachidonic acid, prostaglandins E2 and leukotriene via paw edema model.Results: The acute toxicity of fixed oil was determined at 3, 6 and 10 ml/kg body weight of the mouse. The GC-MS analysis documented 21 various unsaturated and saturated fatty acids elements. The methyl esters of octadecadienoic and linoleic acids were found predominantly at 22.60% and 23.84% respectively. In preliminary screening, FO demonstrated substantial anti-inflammatory capacity (67.87%, **P ˂ 0.01) in carrageenan induced paw edema model at 3 ml/kg body weight. The activity reached a peak value at the 3rd hour and continued persistent until the 5th hour of sample administration. FO displayed dose-dependent inhibition against all inflammogens at 3 ml/kg at 3rd h of the FO administration. These have shown marvelous protection i.e. 64.92%, 68.75%and 58.3% against arachidonic acid, prostaglandin E2 and leukotriene accordingly, at 3 ml/kg. The arachidonic acid antagonist (Caffeic acid) demonstrated 69.43% activity at 100 mg/kg after 3rd h of its administration while in the acute toxicity test, FO has shown no grass lethality at 10 ml/kg dose.Conclusion: According to our findings, the FO of T. stocksianum exhibits inflammation antagonistic potential through both lipoxygenase (LOX) and cyclooxygenase (COX) enzyme inhibition strategies that intensely sustenance the traditional practice of T. stocksianum in the management of multiple pathological inflammatory situations. The computed binding energies of the molecules exposed have synergistic potential to avert inflammation.
Effect of Dilution on the Pollutant Monitoring in Decentralised Treatment Facilities Using Electrical Conductivity Sensors: Experimental and Modelling Insights
Authors: Yu Qiangqiang , Liu Rui , Liang Zhiwei , Song Xiaoyan , Ye Linyi , Chen Lujun
Published: March 2021

Electrical conductivity (EC) is a common and cheap water monitoring sensor, and in some way reflects the water body pollution level qualitatively. In this study, the domestic sewage characteristic analysis for decentralised treatment facilities in plain and mountainous rural areas, Eastern China, showed that influent TN/NH3-N/TP concentrations were strongly and linearly correlated with influent EC values. EC source apportionment indicated that although no single ion in rural domestic sewage dominated the EC value, EC was packed with vast amounts of information on pollutant content and colud be precisely predicted by support vector machine (SVM) regression model (R = 0.9520). According to field investigation and dilution simulation analysis, the mechanism of correlations between influent TN/NH3-N/TP concentrations and EC values was confirmed and attributed to dilutions by background water during pipeline transport. Particularly, although the dilution processes in plain and mountainous areas were similar and the dilution coefficients were speculated to both obey a Poisson distribution, the average dilution coefficient in plain area was 0.35 ± 0.16 with λ=4 while that in mountainous area was 0.23± 0.15 with λ=2. Our results demonstrate that the EC sensor provides a cheap, rapid and reliable alternative pollutant monitoring method for decentralised treatment facilities in rural areas with mechanism clear.
Unmethylated Cytosine phosphate guanine DNA (CpG-DNA) exacerbates liver Kupffer cells (KCs) inflammation through Toll-like receptor 9 (TLR9) in diabetic rats
Authors: Cai Simin , Li Jing , Zhang Xiaoming
Published: March 2021

Recently, gut microbiota for various pathogens has attracted attention. The present study investigated the role of gut microbiota unmethylated cytosine phosphate guanine DNA (CpG-DNA) on liver Kupffer cells (KCs) inflammatory cytokine interleukin-1β (IL-1β) in diabetic rats. We induced diabetic rats models and sequenced the gut microbiota composition of fecal samples. We also applied CpG-DNA and TLR9 inhibitor on KCs to investigate the regulation of inflammatory cytokine IL-1β and Toll-like receptor 9 (TLR9) signaling pathway. We found a significant difference of gut microbiota between the control and the diabetic rats with increased Clostridium. Meanwhile, diabetes could upregulate TLR9 in KCs and increase IL-1β concentration. Furthermore, high concentration of unmethylated CpG-DNA could significantly increase IL-1β secretion while it was suppressed by TLR9 inhibitor in KCs cultured in high glucose medium. Our study suggests that unmethylated CpG-DNA, which was highly expressed in diabetic rats, activated KCs through TLR9, and induced IL-1β secretion in vitro and in vivo which plays an important role in diabetic liver inflammation. It may contribute to the progress of the diabetes.
Prenatal Phthalate Exposure Reduction Through an Integrated Intervention Strategy
Authors: Wu Wei , Cao Liu , Zheng Ting-Ting , Feng Shu-Yu , Ma Guan-Wei , He Ying-Ying , Wu Ping
Published: March 2021

Pregnancy represents a sensitive susceptibility window to phthalate esters (PAEs). In this study, we develop an intervention strategy for reducing the exposure of pregnant women to phthalates. Thirty-five pregnant women, who initially underwent maternity examination, were recruited from an ongoing longitudinal prospective prenatal cohort study. The intervention strategy integrates diet, lifestyle, and environmental factors. Participants were encouraged to modify their behaviors and habits according to the intervention strategy at three different periods. Urine samples were collected from the participants after antenatal examination every month, for 8 months, to measure ten PAEs metabolites. The mono-(2-ethyl-5-hydroxyhexyl) (MEHHP), mono-n-butyl phthalate (MnBP), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) declined significantly after the 1st intervention, while mono-isobutyl phthalate (MiBP) and mono-methyl phthalate (MMP) noticeably reduced after 2nd intervention. The sum of the molar concentrations of MEHP, MEHHP, MEOHP, and MECPP reduced by 20% to 40% during subsequent intervention. In addition, the sum of the molar concentrations of MEP, MnBP, MMP, and MiBP) as well as the sum of the molar concentrations of the ten metabolites also reduced. Our findings suggest that intervention through written recommendations can effectively reduce the burden of phthalates during pregnancy.
MiR-3146 Induces Neutrophil Extracellular Traps to Aggravate Acute Gouty Arthritis
Authors: Shan Lizhen , Yang Di , Feng Fabo , Zhu Danjie , Li Xiaolin
Published: March 2021

MiR-3146 plays an important role in the formation of neutrophil extracellular traps (NETs) during the pathogenesis of acute gouty arthritis (AGA).The aim of our study was to explore the underlying role and molecular mechanism of miR-3146 in the formation of neutrophil extracellular traps (NETs) during the pathogenesis of acute gouty arthritis (AGA). The expression of miR-3146 and sirtuin 1 (SIRT1) was determined by real-time PCR and western blot. The luciferase reporter assay was performed to identify the targeting relationship between miR-3146 and SIRT1. Reactive oxygen species (ROS) production was detected by fluorescent staining. NETs formation was demonstrated via immunofluorescence staining and ELISA method. AGA model was induced in rats to verify the effects of miR-3146 inhibition on histopathological changes and NETs. Here, we found miR-3146 expression was dramatically increased in neutrophils of patients with AGA, presenting higher levels of NETs. Monosodium urate (MSU) crystals significantly increased miR-3146 expression and ROS production in neutrophils. The NETs process was also triggered by MSU crystals. Furthermore, we verified the interaction between miR-3146 and SIRT1. Additionally, antagomir-3146-based therapy effectively inhibited the formation of NETs in rats with AGA. MiR-3146-mediated NETs formation may play a potential role in the pathogenesis of AGA.
Single Nucleotide Polymorphisms of TRAF2 and TRAF5 Gene in Ankylosing Spondylitis: A Case-Control Study
Authors: Xu Shanshan , Kong Jiangping , Huang Li , Xie Huimin , Wang Feier , Zhou Tingting , Zhang Xiaoyi , Yu Lingxiang , Xu Shengqian , Pan Faming
Published: March 2021

ObjectiveTo investigate the role of eight locus polymorphisms of tumor necrosis factor receptor associated factor 2 (TRAF2) and TRAF5 gene and their interaction in the susceptibility to ankylosing spondylitis (AS) in Chinese Han population.MethodsEight single nucleotide polymorphisms (SNPs) (rs3750511, rs10781522, rs17250673, rs59471504, rs6540679, rs12569232, rs4951523, rs7514863) of TRAF2 and TRAF5 gene were genotyped in 673 AS patients and 687 controls.ResultsThe SNPs of TRAF2 and TRAF5 does not indicate a correlation with the susceptibility of AS in Chinese Han population. Genotype frequencies of rs3750511were statistically significant in females between patients and controls. The genotype frequencies of rs12569232 and allele frequencies of rs3750511were statistically significant between groups of different diseases activity. One three-locus model, TRAF2 (rs10781522, rs17250673) and TRAF5 (rs12569232), had a maximum testing accuracy of 52.67% and a maximum cross-validation consistency (10/10) that was significant at the level of P=0.0001, after determined empirically by permutation testing. As to environmental variables, only marginal association was found between sleep quality and AS susceptibility.ConclusionTRAF2 rs3750511 polymorphism may be associated with the susceptibility and severity of AS. Besides, the interaction of TRAF2 and TRAF5 genes may be associated with AS susceptibility, but many open questions remain.
Security Guards’ Knowledge, Attitude and Practice of Cardiopulmonary Resuscitation - the Status Quo and Influencing Factors in China
Authors: Yang Mingzhu , Chai Shuang , Kang Mei , Fang Fang , Zhou Yi , Wan Wen , Peng Youqing
Published: March 2021

Background: First aid provided in public places is life-saving when unexpected emergencies, such as cardiac arrests occur. Security guards who constantly patrol public places can perform or assist cardiopulmonary resuscitation (CPR) in cardiac arrest situations if they are appropriately trained. However, little is known about the status quo of the knowledge, attitude and practice (KAP) of CPR among the security guards in China .Aims: This study aims to investigate the current status quo and explore the influencing factors of the KAP of CPR among security guards, and provide guidance for developing CPR training programs for them in China.Methods: We conducted a convenience sampling on the security guards from 2 tertiary hospitals, 1 airport, 16 commercial buildings, 10 supermarkets and 14 residential complexes in China. Data was collected from the questionnaire about the KAP of CPR given to the security guards enrolled. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of the KAP of CPR.Results: The total scores of each element, the knowledge on CPR among security guards was (25.72±12.31), attitude (31.99±3.94), practice (20.89±4.54), and the total score (78.60±14.70). Multiple linear regression analysis showed that, the workplace of security guards, previous occupations, previous exposure, training and performance of CPR, age, and educational background were the main factors affecting the KAP of CPR of the security guards (all of the P values <0.05).Conclusions: The KAP of CPR among the security guards in Shanghai needs further improvement. The training and intervention program should combine their cultural background, educational background and other influencing factors to improve the level of CPR and first aid ability of security guards.
Outage Performance Analysis for User Cooperative NOMA with Incremental Hybrid Forwarding Protocols
Authors: Li Suyue , Liu Junhuai , Wang Anhong
Published: March 2021

Non-orthogonal multiple access (NOMA) collaborative communication is extremely beneficial to the users with poor channel conditions. It is essential to examine the performance of different NOMA users with superior cooperative forwarding protocols. This paper addresses the user cooperative NOMA system where one strong user (U2) assists one weak user (U1) to forward messages, and investigates the outage performance of both users with hybrid decode-and-amplify forwarding (HDAF) protocol. First, we derive the outage probability of U2 and U1 with HDAF. Secondly, we provide the closed-form expression for outage probability of U1 with the incremental hybrid decode-and-amplify forward (IHDAF) protocol at U2, which can further enhance the outage performance of U1 compared with HDAF. Moreover, we also present the system throughput expression and provide deep analysis on the effect of different forwarding protocols. Numerical results and Monte Carlo simulations jointly confirm the correctness of all the analytic derivations. In addition to saving the energy consumption of U2, IHDAF can make U1 achieve superior outage performance to HDAF. However, the system throughput almost overlap for both schemes given a threshold rate pair.
Understanding the Local Epidemiology of Methicillin-Resistant Staphylococcus aureus by Pulsed-Field Gel Electrophoresis in an Indian Tertiary Care Centre
Authors: Saha Avinandan , Prasad Priyanka , Nataraj Gita
Published: March 2021

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of community and hospital-acquired infections (HAIs). In the year preceding this study, our laboratory reported an MRSA isolation rate of 2% from 50,549 specimens. Molecular typing of MRSA identifies sources of infection, transmission chains and informs infection control practices, and pulsed-field gel electrophoresis (PFGE) is the gold standard. This study was conducted to gain an understanding of the local molecular epidemiology of MRSA in our hospital using PFGE, to inform hospital infection control practices.Methods: This prospective longitudinal study was conducted in the microbiology laboratory of our 2,200-bed tertiary care teaching hospital in Mumbai, India.The antibiotic susceptibility profiles and pulsed-field profiles (PFPs) of 100 consecutive non-duplicate clinical isolates of MRSA were obtained. The PFPs were compared to check for relatedness of isolates. The distribution of various pulsotypes across disciplines and hospital locations was examined.Results: Clinical specimens accounted for 86 (86%) of the MRSA isolates, whilst 14 (14%) were from screening of healthcare workers. Maximum isolates, 68 (68%), were from surgical disciplines. Confirmed HAIs accounted for 25 (25%) MRSA isolates. Seventeen antibiotypes were obtained and there was no correlation between antibiotype and pulsotype. Totally 43 pulsotypes were identified, with most isolates, 40 (40%), belonging to pulsotype 1. Seven clusters were identified. Cluster I had maximum pulsotypes, 14, and 58 (58%) isolates. Isolates belonging to clusters I and II were found in all hospital locations. Relatedness was observed between isolates from HAIs and screening specimens, and between community and HAI isolates.Conclusions: PFGE typing revealed the disciplines at greatest risk from MRSA in our hospital. The commonality between MRSA isolated from HAIs and screening of healthcare workers, and between MRSA isolated from HAIs and from community-acquired infections highlighted the horizontal transmission of MRSA and the need to reinforce infection control measures to limit this.
Are There Variations in Hotspots in Clinical Malaria in Pregnancy and Neonatal Malaria? Evidence From Ghana
Authors: ALLOTEY NAA-KORKOR , Osae Kofi , Mohammed Wahjib , Kotoh Agnes Millicent , Kenu Ernest
Published: March 2021

BackgroundMalaria in pregnancy (MIP) is a significant public health problem, and affects both mother and foetus. MIP has both direct and indirect effects. These direct effects attributed to malaria in pregnancy are clinical malaria in pregnancy and congenital malaria. Although there has been a steady decline of malaria in pregnancy (MIP); reducing from 9% in 2004 to 1.4% in 2016, the decline, does not seem equitable across the country. There was therefore a need to identify areas where clinical MIP and neonatal was high and target them for interventions (neonatal malaria was used because data for malaria was available only for the first 28 days). As a result, this study sought to use routine data to identify areas of high transmission (hotspots) for clinical malaria in pregnancy and neonatal malaria (extrapolating for congenital malaria hotspots).Methods Clinical MIP and neonatal malaria (suspected and confirmed) data were retrieved from the national routine database. Using expected pregnancy and all clinical malaria cases as the denominators of clinical malaria in pregnancy and clinical malaria respectively, the per 1000 cases of malaria in pregnancy and percentage neonatal malaria were calculated for both conditions. These two data sets were fed into ARC GIS software and hotspots spatially determined for both conditions from 2014 to 2016. ResultsVariations in hotspots were identified both chronologically and geospatially for clinical MIP and neonatal malaria respectively. Nevertheless, stable hotspots were found for clinical malaria in pregnancy for the three years and stable hotspots also identified for Neonatal malaria for two years. Congenital malaria was extrapolated from neonatal malaria data only for Bole District in the Northern Region of Ghana for 2015.Conclusions:Hotspots for malaria in pregnancy show marked variation year on year both for clinical malaria in pregnancy and neonatal malaria and vary geospatially. The differences in hotspots in clinical malaria in pregnancy and neonatal malaria also show that neonatal malaria cannot be attributed to congenital malaria and therefore is not the effect of malaria in pregnancy. However, stable hotspots for clinical malaria in pregnancy should be targeted for intervention.
Attenuation and Dispersion in Cancellous Bone: Implication in Developing Ultrasound-Guided Spinal Navigation
Authors: Li Suoyuan , Li Peiyang , Shao Weiwei , Jiao Yang , Li Zhiqiang , Lu Wenjia , Cui Yaoyao , Fan Junjie , Shen Jun
Published: March 2021

Background: The purpose of this study was to understand the acoustic properties of vertebral cancellous bone by combining micro-CT scan data and use this as the theoretical basis for ultrasonic navigation with posterior pedicle screw fixation during spinal fusion surgery. Results: Two bovine spinal cancellous bone blocks and two human spinal allograft bone blocks simulated the condition of cancellous bone in the pedicle screw channel. Transmission experiments were performed on them, including amplitude, attenuation and sound velocity tests. Four unfocused wideband ultrasonic transducers were used for the detection, with the central frequencies of 2.2MHz, 2.5MHz, 3MHz and 12MHz respectively. The results were favorable and stable. The amplitude of the signal decreased with depth penetration (p< 0.05). With the increase of frequency, sound attenuation and sound velocity increased (p< 0.05).Conclusions: In summary, the conclusions lay a theoretical foundation for the ultrasonic navigation system. However, how ultrasound navigation will facilitate pedicle screw insertion in spine surgery remains to be determined. Therefore, ultrasonic guided pedicle screw implantation is effective and promising in theory.
The Power of Partnerships: State Public Health Department Multisector Collaborations in Major Chronic Disease Program Areas
Authors: Tsai Edward , Allen Peg , Saliba Louise F , Brownson Ross C
Published: March 2021

Background

Multisector collaboration between state health departments (SHDs) and diverse community partners is increasingly recognized as important for promoting positive public health outcomes, addressing social determinants of health, and reducing health inequalities. This study investigates collaborations between SHDs and different types of organizations addressing chronic disease in and outside of the health sector.
Methods

SHD employees were randomly selected from the National Association of Chronic Disease Directors membership list for participation in an online survey. Participants were asked about their primary chronic disease work unit (cancer, obesity, tobacco, diabetes, cardiovascular disease, and others), as well as their work unit collaborations (exchange of information/cooperation in activities) with organizations in health and non-health sectors. As a measure of the different organizations SHDs collaborated with in health and non-health sectors, a collaboration heterogeneity score for each program area was calculated. One-way ANOVA with Tukey’s post hoc tests were used to assess differences in collaborator heterogeneity between program areas.
Results

A total of 574 participants were surveyed. Results indicated the cancer program area, along with diabetes and cardiovascular disease, had significantly less collaboration heterogeneity with organizations outside of the health sector compared to the obesity and tobacco program areas.
Conclusions

Evidence suggests that to address social determinants of health and promote health equity, increased public health collaborations with diverse non-health sector community-based settings is critical.
Synthesis of Anatase TiO2 Microspheres and Their Efficient Performance in Dye-sensitized Solar Cell
Authors: V Gowthambabu , Deshpande Murnal , R Govindaraj , K Nithesh Krishna V. , M Leela Charumathi , J Manish Kumar , S Dhilip Vignesh M. , R Isaac Daniel , P Ramasamy
Published: March 2021

Nanomaterials play important role in performance of dye sensitized solar cells. In this paper, highly phase pure anatase TiO2 microspheres were synthesized using a low-cost hydrothermal route. Initially, X-ray diffraction studies and Raman spectroscopic analysis were carried out and the formation of tetragonal structure of TiO2 with the anatase phase was confirmed. The UV-Vis DRS studies showed the excellent reflectance and optical bandgap energy of 3.29 eV. The well-interconnected spherical nanoparticles with different sizes were examined by Field Emission Scanning Electron Microscopic analysis. The fabricated dye-sensitized solar cell (DSSC) composed of prepared TiO2 microspheres as photoanode exhibited a higher power conversion efficiency (PCE) (η) of 5.4% as compared to commercial P25 with PCE of 3.6%. The higher Jsc (12.03 mA/cm2) in the fabricated DSSC due to efficient dye loading capacity and high light-scattering property was also observed.
Profiling of in vitro rumen digestibility, fermentation parameters and fatty acid biohydrogenation of palm kernel cake-based diet supplemented with corn
Authors: Saeed Osama Anwer , Sani Umar M. , Sazili Awis Q. , Akit Henny , Alimon Abdul R. , Samsudin Anjas A.
Published: March 2021

Corn supplementation can enhance the function of rumen and mitigate methane production. Thus, this study aimed to evaluate in vitro rumen digestibility, fermentation parameters and fatty acid biohydrogenation of palm kernel cake-based (PKC) diet substituted with different levels of corn. Corn was substitution into PKC basal diet at the levels; T1= (0% corn + 75.3% PKC), T2= (5% corn + 70.3% PKC) and T3= (10% corn + 65.3% PKC) of the diet. Rumen liquor was obtained from four fistulated Dorper sheep and incubated with 200 mg of each treatment for 24hrs and 72hrs. Net gas production, fermentation kinetics, in vitro organic matter digestibility (IVOMD), in vitro dry matter digestibility (IVDMD), volatile fatty acids (VFA), rumen microbial population and fatty acid biohydrogenation were determined. The results of the in vitro study showed that production of gas increased from 0 hr until 9 hrs with T2 having the highest gas production during this phase. After 48 hrs, the gas production began to decrease gradually with increase in incubation time. No significant differences were observed in the IVDMD, IVOMD, NH3-N, pH and VFA at 72 hrs. However, higher significant methane gas (CH4) production was observed in T3 when compared with T1 and T2. Microbial population did not differ significantly between treatment groups for total bacteria, F. succinogenes and R. flavefaciens. The rates of biohydrogenation were not affected by corn substitution although a significant difference was observed in that of C18:1n9. In conclusion, corn substitution maintained fermentation characteristics with increasing of unsaturated fatty acids.
Adaptive TCS creation and assignment mechanism for cognitive radio network using Golden Eagle optimized Hybrid Multilayer Perceptron-Convolutional Neural Network
Authors: Javar Anjana Devi , Sriniva V. Prasanna
Published: March 2021

The authors have requested that this preprint be removed from Research Square.
Dexamethasone Implant Improves Anatomic Response to Anti-VEGF Therapy in Treatment-Resistant Polypoidal Choroidal Vasculopathy
Authors: Mallikarjun Kushanth , Narayanan Raja , Raman Rajiv , Mohamed Ashik , Shanmugam Mahesh , Apte Rajendra , Padhy Srikant
Published: March 2021

Background: A significant proportion of eyes with polypoidal choroidal vasculopathy (PCV) can be resistant to anti-vascular endothelial growth factor (VEGF) injections. We evaluated the efficacy of combination of Dexamethasone intravitreal implant (DXI) and anti-VEGF therapy in eyes resistant to anti-VEGF monotherapy. Materials and Methods: In this retrospective study, polypoidal choroidal vasculopathy (PCV) resistant to anti-VEGF injections were additionally injected with a Dexamethasone implant along with an anti-VEGF agent. Best-corrected visual acuity (BCVA), slit lamp examination, intraocular pressure, fundus evaluation and optical coherence tomography (OCT) data were analyzed. Anatomical response on OCT was the primary outcome measure. Gain in visual acuity, and injection-free interval after the Dexamethasone implant were evaluated as secondary outcome measures. Results: Twelve eyes of 11 patients were included in the study. The mean age of patients was 70.2 ± 11.8 years, and there were 8 females. The mean follow-up duration after DXI was 24.5 ±11 months. The mean number of anti-VEGF injections before DXI was 4.2 ± 1.9. The mean injection-free interval in these patients after DXI was 4.7± 0.6 months, which was significantly greater than the pre-injection mean of 1.6 ± 0.4 months (p<0.001). The median log MAR BCVA immediately prior to DXI was 0.41 (Interquartile Range IQR 0.30-1.02) and after injection was 0.60 (IQR 0.27-1.03), which was not significant (p=0.59). The median OCT thickness after DXI in was 305 microns (IQR 206-417), which was significantly less than the pre-injection OCT thickness of 547 microns (IQR 432-685) (p=0.005). The mean IOP before DXI was 14.7 ± 2.3 mm Hg, and after the injection was 14.3 ± 2.7 mm Hg (p=0.36). Conclusions: Dexamethasone implant combined with anti-VEGF treatment can prolong the treatment-free interval in eyes with PCV resistant to anti-VEGF injection, while maintaining visual acuity.
Lung Adenocarcinoma Complicated with a Carcinoid Microtumor: A Case Report and Literature Review
Authors: Xu Yanzhao , he Ming , Sun Bokang , Su Peng , Zhang Fan , Gai Chunyue , Tian Ziqiang
Published: March 2021

Background: Adenocarcinoma is the most common primary lung malignant tumor. However, pulmonary carcinoid tumorlets are rare neuroendocrine tumors, and the coexistence of adenocarcinoma and pulmonary carcinoid tumorlets is extremely rare. Herein, we describe a case of lung adenocarcinoma complicated with carcinoid tumorlets.Case presentation: A 71-year-old female patient was admitted to the hospital after physical examination, multiple micronodules were in the inferior lobe of the left lung and right lung for 2 years, and a tumor was in the superior lobe of the left lung for 1 month. The patient underwent resection of the superior lobe of the left lung and wedge resection of the inferior lobe of the left lung by Video-assisted Thoracoscopic Surgery(VATS). The pathology of the superior lobe of the left lung was adenocarcinoma (pathological stage pT1cN0M0, IA3 stage), and the pathology of the inferior lobe of the left lung was carcinoid tumorlets. The patient was discharged from the hospital one week after the operation and recovered well after follow-up without recurrence.Conclusions: The lack of understanding of carcinoid tumorlets in the clinic causes their misdiagnosis or missed diagnosis. At the same time, the lack of understand also suggests that we should pay attention not only to mass-type lung tumors but also to pulmonary micronodules.
Chronic Transient Hypoxia Alleviates High Fat Diet-Induced Obesity and Fatty Liver in C57 Mice by Upregulating Epinephrine Levels and Activation of AMPK
Authors: Luo Yunfei , Luo Zhijun
Published: March 2021

Background

According to epidemiologic studies, it was found that people living in high altitude areas have a lower prevalence of obesity and diabetes, and the main environmental differences between high altitude areas and plain areas are temperature and oxygen concentration. In this study, we investigated the effect of chronic transient hypoxia on obesity and fatty liver caused by high-fat diet in mice.
Methods

Put the mice under 10% oxygen concentration for 1 hour every day, this method is different from high altitude hypoxia and will not cause a series of acute altitude sicknesses. Intraperitoneal injection of epinephrine or propranolol was employed to examine the effect of chronic transient hypoxia on HFD-induced obesity, hyperglycemia and hepatic lipid accumulation.
Results

It showed that chronic transient hypoxia environment reduces the weight of mice and improve glucose tolerance, reduce the fat content of mice and alleviate fatty liver, reduces liver fat synthesis, promotes the expression M2 phenotype of macrophage genes in liver and thermogenic genes in brown fat. Furthermore, we showed that blocking the rise of epinephrine will compromise the chronic transient hypoxia environment beneficial ability to obesity and fatty liver, diminished expression of the liver AMPK phosphorylation and CD206.
Conclusions

These results suggest that chronic transient hypoxia activation of AMPK, induction of M2 type macrophage marker CD206 expression in the liver leads to significant weight loss and remission the severity of fatty liver through the adrenergic system.
An Impact of COVID-19 On Dental and Oral Health Care Workers: An Online Survey in Nepal
Authors: Deo Saroj Prasad , Baral Dharanidhar
Published: March 2021

Background

COVID-19 (COrona VIrus Disease-19) outbreak is an alarming situation for all health care workers. Dental and oral health care workers (DOCHWs) are invariably at a higher risk of getting infected or transmitting disease due to the nature and duration of work. The objective is to determine the effect of the COVID-19 pandemic on Nepalese dental and oral health care workers and their practices.
Methods

A cross-sectional observational, online survey was designed and conducted via Google form from 24 June 2020 to 13 July 2020 among DOHCWs of Nepal. The study tool developed after reviewing pertinent literature and international guidelines.
Results

A total of 51.9% were aged 20 to 29 years, 61.7% were male, 52.6% were single; 92.5% had no morbidity. Of the respondents, majority 60.2% of DOCHWs were working in routine duties on the COVID-19 crisis. They reduced their current practice to before the pandemic; 48.2 % of them working less than 20 hours per week, while only 10.5 % of them working more than 40 hours per week. Moreover, 73.7% performed only selective or lesser procedure; 18% closed dental practices / stayed home; only 1.5% worked more; 6.8% shifted practice to online (teledentistry). The majority of the respondents restricted their activity to an emergency (21%) and urgent procedures (22.7%). A considerable proportion of participants reported symptoms of depression (21.9%), anxiety (24.2%), and distress (8.4%). Bivariate analysis showed a statistically significant level of satisfaction with logistic support provided by the administrative agency in the different workplace (oral health service centre) with relation to the availability of masks other than N95, N99 (p = 0.04), availability of PPEs (p = 0.06) and facility of cleaning area (p = 0.01).
Conclusion

The impact of the COVID-19 pandemic among DOHCWs is widespread and adversely affect the personal, professional and academic lives of DOHCWs of Nepal. The participants reported experiencing psychological burden, precipitated by financial burden and worries about an uncertain future.
Eyelid Metastasis as the Initial Presentation of a Renal Cell Carcinoma: a Case Report and Review of the Literature.
Authors: Fang QiXiang , Xie Na , Chen Wei , Zhu Guodong , Zeng Jin , Wu Dapeng
Published: March 2021

Introduction: Renal clear cell carcinoma(ccRCC) accounts for about 85% of patients with renal carcinoma and is the most common pathological type of renal cancer. Renal clear cell carcinomas usually metastasize to the lungs, lymph nodes, liver, bones, and brain, with rare skin metastases, especially to the eyelids. In this study, we report the third current case of renal clear cell carcinoma with eyelid mass as its initial presentation.Case presentation: In this study, we describe in detail the case of a 62-year-old male patient with clear cell carcinoma of the kidney whose first symptom was a mass of the right eyelid. The patient had no clinical manifestations other than eyelid mass before the diagnosis of renal clear cell carcinoma. After resection of eyelid mass, postoperative pathological and immunohistochemical studies showed clear cell carcinoma of the kidney. Subsequently, a computed tomography scan disclosed bilateral renal tumors, bilateral adrenal nodules, and nodules in the upper lobe of the left lung. At the time of writing, the patient was receiving sunitinib treatment and receiving regular outpatient follow-up. Discussion and conclusion: Metastasis of renal carcinoma to the eye is rare, especially with an eyelid mass as the initial presentation. If they occur before the diagnosis of cancer or years after nephrectomy, the diagnosis of the tumor may be missed. In this study, we report the rare case and review reports of renal cell carcinoma metastasizing to the eye to raise our awareness of this rare phenomenon.
Hybrid Learning Model Integrated Into Critical Care Practice in Nursing Students A Mixed Study.
Authors: Gil-Mateu Elsa , Reverté-Villarroya Sílvia , Casanovas-Garrigós Georgina , Albacar-Riboó Núria
Published: March 2021

Background: Active learning methodologies have been widely adopted into undergraduate healthcare, and a strategic framework that guides learning to the students, being blended-learning which combines the best of face-to-face and virtual learning. Therefore, this study aimed to identify the key elements from a virtual forum in achieving competencies in clinical practice in critical care, and to evaluate the b-learning process of undergraduates nursing through a virtual forum on Moodle Platform.Methods: Mixed research conducted. A qualitative descriptive phenomenological methodology informed by virtual forum and quantitative descriptive method from self-reported questionnaire. An intentional sample of nursing students of clinical practice in critical care units from fourth-year undergraduate in Rovira Virgili University (Spain) was employed. Data source included virtual forum (sixteen weeks) and final seminar classroom included face-to-face. Sociodemographic and forum variables were evaluated questionnaire ad hoc (fifty questions): learning, tutoring, satisfaction, and self-evaluation about virtual forum with Likert scores 1:(strongly disagree) to 4:(strongly agree).Results: It was observed 51 nursing students, 70.6% of students were women (n.36) with an average of age of 21.18 years (standard deviation 2,186). In the qualitative analysis of the forums, six main categories were extracted: The humanization of care (n=93), Communication (n=69), Learning (n =92), Professional knowledge (n=55), Clinical Safety (n=66), Complexity (n=101). The analysis of the questionnaire shows: The evaluation learning, tutoring, self-evaluation about virtual forum, and satisfaction. The items that have presented significant differences (p<0.05) are six items and by (p<0.01) one item.Conclusion: The dynamized forum allows accompanying the students while their clinical practice in critically ill patients in their learning process to develop critical thinking. It’s also a useful tool for achieving results, in scenarios that have become the result of social confinements, which will lead to a paradigm change in universal education.