bluuebunny/crossref_metadata_2025 huggingface dataset:
Enrichment differentiation of human induced pluripotent stem cells into sinoatrial node-like cells by combined modulation of BMP, FGF and RA signaling pathways
Authors: Liu Feng , Fang YiBing , Hou XiaoJie , Yan Ying , Xiao HaiYing , Zuo DongChuan , Wen Jing , Wang LinLi , Zhou Zhichao , Dang XiTong , Zhou Rui , Liao Bin
Published: April 2020

Background: Biological pacemakers derived from pluripotent stem cell (PSC) have been considered as a potential therapeutic surrogate for sick sinus syndrome. So it’s essential to develop high efficient strategies for enrichment of sinoatrial node-like cells (SANLC) as seed cells for biological pacemakers. It has been reported that BMP, FGF and RA signaling pathways are involved in specification of different cardiomyocyte subtypes, pacemaker, ventricular, and atrial cells. Methods: During the differentiation process from human-induced pluripotent stem cell (hiPSC) to cardiomyocyte through small molecule based temporal modulation of the Wnt signaling pathway, signaling of BMP, FGF and RA was manipulated at cardiac mesoderm stage. qRT-PCR, immunofluorescence, flow cytometry and whole cell patch clamp were used to identify the SANLC. Results: qRT-PCR results showed that manipulating each one of bone morphogenetic protein (BMP), fibroblast growth factor (FGF) and retinoid acid (RA) signaling was effective for the upregulation of SANLC markers. Moreover, combined modulation of these three pathways displayed the best efficiency for the expression of SANLC markers, which was further confirmed at protein level using immunofluorescence and flow cytometry. Finally, the electrophysiological characteristics of upregulated SANLC were verified by patch clamp method. Conclusion: An efficient transgene-independent differentiation protocol for generating SANLC from hiPSC was developed, in which combined modulating BMP, FGF and RA signaling at cardiac mesoderm stage generates SANLC at high efficiency. This may serve as a potential approach for biological pacemaker construction.
Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa
Authors: MAKHADO LUFUNO , Davhana-Maselesele Mashudu , Lebese Rachel Tsakani , Maputle Sonto Maria
Published: April 2020

Background: Globally the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% with 3% global health workforce and this an alarming rate that World Health Organization (WHO) declared African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for these countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The purpose of the study was to determine factors facilitating trained nurse-initiated management of antiretroviral therapy (NIMART) nurses’ adherence to TB/HIV treatment guidelines in KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa.Design: The study was qualitative, explorative and descriptive in nature. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussion was conducted. Data analysis was through the used of ATLAS T.I. software program (version 7.0) and followed the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and ethical consideration were ensured.Results: The following one theme namely; marked identified needs to be met to promote adherence to treatment guidelines and sub-themes emerged from raw data: Expected positive attitudinal needs outlined and an outline of a positive behavioural change. Conclusion: Factors such as continuous training, support supervision and improved relationships with colleagues need to be enhanced to enable NIMART nurses to adhere to treatment guideline.
Achieving objective response in treatment of non-resectable neuroendocrine tumors does not predict longer time to progression compared to achieving stable disease
Authors: Thiis-Evensen Espen , Poole Amalie Christine , Nguyen Hong-Thien Thi , Sponheim Jon
Published: April 2020

Background: There are several treatment modalities for unresectable neuroendocrine tumors. Traditionally, the aim of these treatments has been to reduce the tumor load; referred to as objective response (OR). Less emphasis has been put on inducing the tumors to stop growing without a reduction in total tumor load; termed as stable disease (SD). We wanted to investigate whether achieving OR compared to obtaining SD predicted a longer time to progression (TTP) in patients with neuroendocrine tumors (WHO Grade 1 and 2) treated with peptide receptor radionuclide therapy, chemotherapy or molecular targeted therapy. Methods : Patients treated with either peptide receptor radionuclide therapy (PRRT) with 177 Lutetium-DOTA-octreotate, the chemotherapy combination streptozotocin/5-fluorouracil or everolimus were retrospectively assessed to evaluate the effect of the treatments on disease progression. We analyzed the TTP for patients for each treatment modality and compared the TTP between those who achieved OR and those who achieved SD. Results: Altogether 56 patients treated with PRRT, 32 treated with streptozotocin/5-fluorouracil and 52 treated with everolimus were included in the analyses. The median TTP for those treated with PRRT and achieving OR was 31 months, the TTP for those achieving SD was 43 months (p=0,2). For patients treated with streptozotocin/5-fluorouracil the results were: OR: 18 months, SD: 23 months (p=0,9) and for those treated with everolimus; OR: 9 months, SD: 20 months (p=0,5), respectively. We found no differences between patients achieving OR compared to SD regarding age, sex, stage, primary tumor location, Ki-67% or ongoing treatment with somatostatinanalogues. Conclusions: We found no treatment benefit with regard to TTP for our patients that experienced OR compared to those who achieved SD, but a trend toward longer TTP among patients with SD.
Effect and Mechanism of Lycium Barbarum Polysaccharide on Hyperglycemia and Inflammation in Diabetic KKAy Mice
Authors: yin hong , Deng Shuying , Bai Lili , Li Lihua , Liu Tingting , Cai Huizhen
Published: April 2020

Scope The aim of this study is to examine whether lycium barbarum polysaccharide (LBP) supplementation improves hyperglycemia and inflammation in diabetic KKAy mice. Methods The successfully established diabetic KKAy mice are randomized into five groups: diabetic model, metformin, low‐dose LBP, middle‐dose LBP, and high‐dose LBP . C57BL/6J mice are fed a chow diet as normal control . The blood glucose and body weight of mice were measured at different time points. At the end of 90 days, serum inflammatory factors were determined with ELISA kits. The expression of TLR4, MyD88, TRAF6, IκKβ, IκB, P-IκB and nuclear NF-κB proteins in mouse peritoneal macrophages were detected by Western Blotting. Results Blood glucose decreased significantly after the intervention among low-, medium-dose LBP groups and Met group ( P <0.05). Met (40 mg/kg) inhibited the levels of IL-1β, TNF-α and IL-6 and elevated IL-10 level ( P <0.05). ELISA results showed that LBP promoted serum levels of IL-10 and decreased TNF-α level ( P <0.05). Compared with model group, KKAy mice in Met group expressed lower protein levels of MyD88, TRAF6, IκKβ, nuclear NF-κB and higher expression of IκB ( P <0.05); The expression of TLR4, MyD88, TRAF6, IκKβ and nuclear NF-κB protein in low- and medium-doses LBP groups were significantly declined ( P <0.05). Conclusion These findings indicate that dietary supplementation with LBP can improve hyperglycemia and inflammation in diabetic KKAy mice, which can be associated with potential benefits to human health.
Insights for the future of health system partnerships in low- and middle-income countries
Authors: Fanelli Simone , Salvatore Fiorella Pia , De Pascale Gianluigi , Faccilongo Nicola
Published: April 2020

Background: Despite growing support for the private sector involvement in the provision of public health services in Low- and Middle-Income Countries (LMICs), a lack of clear information on the future of the provision of such services restricts the ability of policy-makers to assess how feasible integration between public and private actors may be, especially in LMICs.Methods: This paper presents a structured literature review performed to comprehend the dynamics and boundaries of public-private partnerships for the healthcare sector in LMICs. A total of 723 articles indexed in Scopus were initially submitted to bibliometric analysis. Finally, 148 articles published in several academic journals were selected for independent full-text review by two researchers. Content analysis was made in order to minimise mistakes in interpreting the findings of studies in the sample.Results: Public-private partnerships identified through the content analysis were categorised into four research areas: 1) Transfer of resources; 2) Co-production of goods, services and health practices; 3) Governance networks; 4) Criteria for successful partnership development. The results provide a useful overview of the phenomenon and a useful baseline for policy implications of evolution of partnerships in LMIC healthcare sectors.Conclusions: The structured literature Review thus carries out a mapping of the areas and sectors where governments need support, and a careful analysis of all those factors which may or not facilitate a public-private partnership in LMICs.
Antioxidant Evaluation and Chemo-Profiling of Non-conventional Curcuma Species as Conservation of Drug Targeting Molecule
Authors: Jain Akanksha , Jain Parag
Published: April 2020

The objective of the present study was to determine and compare antioxidant activities of different species of Curcuma i.e. Curcuma longa, Curcuma caesia and Curcuma aromatic and their chemoprofiling for conservation of highest yield plants. The functional group analysis of the plants extract were determined by FTIR and structural features of phyto-constituents and Chemo-profiling of ethanol fractions of all targeted Curcuma species showing highest activity were analyzed by GC–MS/MS. Ethanolic extract of C. aromatica (ECA) was exhibited to determine high radical scavenging activity against DPPH (92.12%), lipid Peroxidation (85.13 ± 0.23%), nitric oxide scavenging, total reducing power (700.83 ± 8.14 μg/mg) and ferric reducing power assay. In ABTS·+ and phosphomolybdate assay Curcuma species showed a significant difference ranging from 67.53 – 98.57%. Furthermore, the amount of total phenolic and flavonoid content ranged from 3.63± 1.06 – 545.77 ± 2.76 μg/mg eq GAE and 21.18 –101.29 μg/mg eq QUE respectively. The results indicated that the ethanolic extracts showed highest in vitro antioxidant activity. It can be conclude from the study that Curcuma species may serve as an important bioresource as an antioxidant drug.
Online patient simulation training to improve clinical reasoning: A feasibility randomised controlled trial
Authors: Plackett Ruth , Kassianos Angelos P , Kambouri Maria , Kay Natasha , Mylan Sophie , Hopwood Jenny , Schartau Patricia , Gray Shani , Timmis Jessica , Bennett Sarah , Valerio Chris , Rodrigues Veena , Player Emily , Hamilton Willie , Raine Rosalind , Duffy Stephen , Sheringham Jessica
Published: April 2020

Background: Online patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST — the electronic Clinical Reasoning Educational Simulation Tool.Methods: A feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after one week and a patient case after one month.Results: Across schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After one week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students’ ability to gather essential information from patients over controls (OR =1.4; 95% CI 1.1-1.7, n =148). Of the intervention group, most (84/98, 82%) agreed eCREST helped them to learn clinical reasoning skills.Conclusions: eCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness.
Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based study
Authors: Kabootari Maryam , Asgari Samaneh , Ghavam Seyedeh Maryam , Azizi Fereidoun , Hadaegh Farzad
Published: April 2020

Background: To assess the association between fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2h-PCPG) as continuous or categorical variables with risk of recurrent cardiovascular disease (CVD) and incident diabetes among subjects with history of previous CVD. Methods: In a prospective population-based cohort, a total of 335 Iranians aged ≥30 years, with history of CVD and free of known diabetes were included. Prediabetes was defined as impaired fasting glucose (IFG) according to the criteria of the American Diabetes Association (ADA) [IFG-ADA; FPG: 5.6-6.9 mmol/L], the World Health Organization (WHO) expert group (IFG-WHO; FPG: 6.1-6.9 mmol/L) and impaired glucose tolerance [IGT: 2h-PCPG: 7.8-11.0 mmol/L]. Cox’s proportional hazard models adjusted for traditional risk factors were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different glucose intolerance for outcomes of interest. Results: During a median follow-up of 15.8 (IQR, 10.7-16.5) years, 178 CVD (hard event including death, myocardial infarction and stroke=69) events occurred. Regarding FPG, only IFG-ADA was associated with significant higher risk of hard CVD in the fully adjusted model (HR, 1.73, 95% CI: 1.04-2.89). Moreover, newly diagnosed diabetes (FPG≥7 mmol/L) was an independent risk of CVD (2.11: 1.22-3.66). Focusing on 2h-PCPG, subjects with newly diagnosed diabetes (2h-PCPG ≥ 11.1 mmol/L) had moderately increased risk of hard coronary heart disease (2.02:0.91-4.47, P=0.08). The multivariate HRs (95% CI) associated with 1 SD increase in FPG and 2h-PCPG was 1.16 (1.01–1.33) and 1.19 (1.02–1.38) for CVD, respectively. Among population free of diabetes at baseline (n=270), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes in multivariate analysis (all HRs > 4, P< 0.001); significant associations were also found for FPG and 2h-PCPG as continuous variables (all HRs for 1-SD increase > 2, all P < 0.001). Conclusions: Among subjects with stable CVD, both FPG and 2h-PCPG as continuous variables was associated with higher risk of recurrent CVD. However, only IFG-ADA was independent predictor of hard CVD events. Also, newly diagnosed diabetes, using FPG criteria, was associated with a significant risk of CVD. IFG-ADA, IFG-WHO and IGT were all significant predictors of incident diabetes.
A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.
Authors: Mohanty Itismita , Niyonsenga Theo , Cochrane Tom , Rickwood Debra
Published: April 2020

Background: This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes while controlling for socio-demographic, physical activity level and other economic confounders. More importantly, the study estimated the magnitude of small local area (SA1) level variation along with individual level variation in informal carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional study using data from the Household Income and Labour Dynamics of Australia survey, wave 14 (2014). It included Australians aged 15 years and older that are surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 small local areas (SA1) in Australia. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. The health outcome measures exhibited significant variation across small areas (SA1s) in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in health. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and even more beneficial for carers compared to non-carers.Conclusion: It seems the positive influence of social capital for carers, helps them in coping with the negative impact of their caregiving on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Clinical analysis and predictive factors associated with improved visual acuity of infectious endophthalmitis
Authors: Gao Zhao , Zhang Yunda , Gao Xiaohong , Zhang Ximei , Ma Tao , Li Gaiyun , Wang Jingjing , Yan Hua
Published: April 2020

Background: To describe the clinical characteristics and analyze the predictive factors associated with improved visual acuity of 359 patients with infectious endophthalmitis. Methods: This study retrospectively analyzed 359 eyes of 359 patients with infectious endophthalmitis from January 2014 to December 2018. The findings summarized some epidemiological characteristics of these patients, including age, sex, occupation, patient visit time, etiology, causative organisms, therapy and best-corrected visual acuity (BCVA). Multivariate logistic regression was performed to predict the relative factors of improved visual acuity (VA). Results: Overall, 283(78.83%) patients were male.The mean age was 48.0 ± 18.27 years. Ocular truma, especially the open globe injuries (246, 68.5%) was the most common etiology of infectious endophthalmitis in this study. The etiologies of infectious endophthalmitis were open globe injuries (68.5%), intraocular surgery (22.6%), cornea ulcer-associated causes (6.7%), and endogenous causes (2.2%). In the etiology classification and visual acuity improvement group, the statistically significant difference in factors such as age, sex, patient visit time, pre-therapy VA,etc. The average Logarithm of the Minimum Angle of Resolution (logMAR) BCVA on pre-therapy was 2.28 ± 0.60, and it had significantly improved to 1.67 ± 0.83 on post-therapy (P<0.05). Logistic regression analysis showed that visit time>7 day (P=0.034, OR=0.522, 95%CI: 0.286-0.953),pre-therapy VA≦logMAR 2.3(P=0.032 ,OR=1.809, 95%CI：1.052-3.110 ), etiology of PS (vs. PT; P=0.023, OR=2.100, 95%CI:1.109-3.974) and etiology of CA(vs. PT; P=0.005, OR=0.202, 95%CI:0.066-0.621) were significantly associated with improved VA after adjusting for possible confounding factors. Conclusion: Among the patients with infectious endophthalmitis, middle-aged males, especially farmers and workers, accounted for a large proportion. Open globe injuries was the main cause and gram-positive bacteria was the major causative organisms. The final visual outcomes seem to vary according to the type of endophthalmitis, but early treatment and good initial visual acuity are important factors for visual acuity improvement.
Characterization and transcriptome analysis of a dominant genic male sterile cotton mutant
Authors: Cheng Xinqi , Zhang Xinyu , Xue Fei , Zhu Shouhong , Li Yanjun , Zhu Qianhao , Liu Feng , Sun Jie
Published: April 2020

Background : Male sterility is an efficient trait for hybrid seed production and germplasm innovation. Until now, most studies on male sterility were on cytoplasmic and recessive genic sterility, with few on dominant genic male sterility, especially in cotton, due to lack of such mutant.Results : We discovered a natural male sterile (MS) Sea Island cotton ( G. barbadense ) mutant, Genetic analysis showed the mutation was caused by a dominant mutation in a single nuclear gene. Comparative cytological observation of anther sections from MS and WT uncovered cellular differences in anther at and after the tetrad stage of pollen mother cells (PMC). In the MS anthers, the outer wall of pollen grains was free of spinules, the tapetum was vacuolated and showed delayed degradation, consequently, no functional pollen grains. Comparison of transcriptomes from meiosis, tetrad, mononuclear and binuclear pollen, and pollen maturation stages identified 13,783 non-redundant differentially expressed genes (DEGs) between MS and WT. Based on the number of DEGs, analyses of enriched GO terms and KEGG pathways, it was evident that significant transcriptomic changes occurred at and after the tetrad stage, consistent with cytological observation, and that the major differences were on metabolism of starch, sucrose, ascorbate, aldarate, alanine, aspartate and glutamate, and biosynthesis of cutin, suberine and wax. WGCNA analysis identified five modules containing 920 genes highly related to anther development, especially the greenyellow module with 54 genes that was highly associated with PMC meiosis and tetrad formation. A NAC transcription factor ( Gh_D11G2469 ) was identified as a hub gene for this module, which warrants further functional characterization.Conclusions : We demonstrated that the MS trait was controlled by a single dominant nuclear gene and caused by delayed tapetum degradation at the tetrad stage. Comparative transcriptome analysis and gene network construction identified DEGs, enriched GO terms and metabolic pathways, and hub genes potentially associated with anther development and the MS trait, which will contribute to important ideas and basis of the experimental data related to the molecular mechanism of DGMS and the innovation of cotton germplasm resources.
Association between intestinal microbiota composition and tail-biting in pigs
Authors: Rabhi Nassima , Thibodeau Alexandre , Côté Jean-Charles , Devillers Nicolas , Laplante Benoit , Fravalo Philippe , Larivière-Gauthier Guillaume , Thériault William P. , Faucitano Luigi , Beauchamp Guy , Quessy Sylvain
Published: April 2020

Background: Tail-biting (TB) is a serious behavioral disorder in pigs. It is defined as a pig chewing the tail of another pig. It is an important challenge in swine production as it impacts the animal welfare, its health and the economics and safety of the pork meat supply chain. Some treatments have been proposed but have not proven optimal. Nutrition, feed type and composition, appears to be an important factor in TB behavior, perhaps by modulating the intestinal microbiota (IM). In humans, IM is increasingly recognized as a modulator of behavior. Our aim was to assess an association between TB behavior and IM in pigs through comparisons of IM in groups of biter or bitten pigs to the IM in a non-biter and non-bitten negative control group, and through comparisons of IM between the biter and bitten groups. Each group, composed of 12 pigs, was formed at the beginning of the growing/finishing phase based on a target behavior analysis centered on TB behavior for the biter group and a score of damages caused to the tail for the bitten group. Fecal and blood samples were collected from each pig during a TB episode, at time 0, t0, and after a TB episode, four weeks later, at time 1, t1. Serum cortisol level was determined by ELISA and used as an indicator of stress. The pig’s fecal microbiota was analyzed from DNA extracted from freshly collected fecal matter using amplicon sequencing of the V4 hypervariable region of the 16S rRNA gene. Results: Serum cortisol levels were significantly higher in either the biter or bitten pig groups compared to the negative control group ( p =0.02 and p =0.01, respectively). Interestingly, no significant difference was revealed between the biter and bitten groups. The microbiota alpha-diversity was not significantly different between all groups, biter, bitten and negative control. Analyses of beta-diversity, however, revealed a significant difference between either the biter or the bitten group in comparison to the negative control group in terms of structure and composition of the microbiota. Lactobacillus were significantly more abundant in the negative control group compared to the two other groups ( p =0.001). No significant difference was revealed between the biter and bitten groups. Quantitative real-time PCR (qPCR) confirmed that lactobacilli were more abundant in the negative control group. Conclusions: This study demonstrates that TB behavior is associated to the IM composition in pigs.
Availability, Price and Affordability of WHO Priority Maternal and Child Health Medicine in Public Health Facilities of Dessie, North-East Ethiopia
Authors: Hailu Abel Demerew , Mohammed Solomon Ahmed
Published: April 2020

Background: Access to health care is a fundamental human right and the provision of affordable, high quality and appropriate medicines for Maternal and child health is a vital component of a well-functioning health system. The study assessed the availability, price and affordability of WHO priority maternal and child medicines in public health facilities, Dessie, North – East Ethiopia.Methods: Retrospective cross-sectional study design was conducted in Dessie town from November 2018 to February 2019. A standard checklist adapted from Logistics Indicator Assessment Tool and WHO/HAI was used to collect data on the availability, affordability, and price of 45 priority life-saving medicines from eight public health centers and two public hospitals. Descriptive statistics (percent and median) were computed for availability and prices. Affordability was reported in terms of the daily wage of the lowest-paid unskilled government worker.Results: Twenty-two medicines were not completely managed. The overall availability of WHO priority maternal and child medicines was 34.02%. The mean numbers of stock outs was 3.9 and mean number of 128.9 days. The mean average point availability was 33.5 % and 7 medicines stock out on the days of assessment. From WHO priority maternal and child medicines, 4 (40%) of the products were unaffordable and 5 (55.5%) had higher price compared to international prices. Ceftriaxone 1gm, ceftriaxone 500mg and hydralazine 20mg injection requires wages of 6.58, 8.01, and 5.02 to cover specific maternal health problems respectively. Median price ratio of priority lifesaving maternal and child medicines in public health facility ranged from 0.65 to 3.19. Conclusions: The average mean period and point mean availability was very low. The availed products were encountered with high number of stock outs and unaffordable. Strict control of inventory is recommended to have steady supply of these essential medicines and improve quality of health service. Keywords: Availability, Affordability, Price, Medicines and Maternal and child.
Adaptation and preliminary psychometric properties of three self-stigma outcome measures for people living with dementia
Authors: Bhatt Jemini , Stoner Charlotte R , Scior Katrina , Charlesworth Georgina
Published: April 2020

Background: A diagnosis of dementia presents individuals with both social and psychological challenges but research on self-stigma in dementia has been largely confined to qualitative approaches due to a lack of robust outcome measures that assess change. The Stigma Impact Scale is the most commonly used measure of self-stigma in dementia but its suitability as a tool to assess change in a diverse UK population is unclear. Thus, the aim of this study was to identify, adapt and evaluate the acceptability and psychometric properties of self-stigma measures for people with dementia for use as measures of change.

Method: A four-stage approach was used to identify, adapt and test self-stigma measures in a UK population who had received a diagnosis of dementia: 1) psychometric outcome measures were extracted based on the evidence base of an anti-stigma intervention that guided the current work, 2) identified measures were assessed for psychometric quality according to Terwee criteria, 3) modifications were made for culture (UK) and condition (dementia rather than mental health) through stakeholder consultations (researchers in fields of dementia and stigma; experts by experience in living with, or caring for persons with dementia), and 4) modified measures were pilot tested in a small sample of people living with dementia (N=40) for acceptability, and preliminary psychometric properties (internal consistency, test-retest, concurrent and convergent validity).

Results: Seven measures were identified but most were of low quality (Terwee range: 0-4). Three measures were considered and modifiable by stakeholders. Pilot testing indicated data were normally distributed. Almost all measures demonstrated acceptable internal consistency (except the Stigma Stress Scale total and internalized shame subscale), test retest reliability, concurrent validity and convergent validity, with some exceptions.

Conclusion: The Secrecy subscale, Stigma Impact Scale and Stigma Stress Scale were acceptable for use in a UK population of people living with dementia. However, further psychometric analysis is required before such measures can be implemented in psychosocial research.
Short-Term Projection of COVID 19 Cases in Kenya using an Exponential Model
Authors: Kirichu Samuel Kiruri
Published: April 2020

Introduction: The COVID-19 disease has spread to over 200 countries and territories since the first case was recorded in Wuhan, China in December 2019. In Kenya, the first case of COVID-19 was recorded on 13th March 2020, since then over one hundred cases have been confirmed, and three deaths recorded as of 2nd April 2020. With the rapid changing situation, timely and reliable data is required for monitoring, planning and rapid decision making with an aim of reversing the already deteriorating situation (economic, health, learning among others) in the country. Methods: The study used the exponential model to project the expected daily cumulative cases in Kenya within the first 40 days. The study opted to do a short time prediction owing to the fact that the scenario is rapidly changing. Data used in the analysis was obtained from the daily updates by the Kenya Ministry of Health, and analysis was done using Stata Version 15 and MS Excel 2010. Results: The Case Fatality Rate on day 21 was estimated as 2.7% (95% CI 0.01 – 7.80), with varying daily estimates as expected. The model estimated that the 1,000 confirmed cases will be reached by 14th April 2020 while the 4,000 cases will be reached by 21st April 2020. The results indicate that it will take 33 days for Kenya to reach the 1,000 confirmed cases and 40 days to reach the 4,000 casesConclusion: Massive screening and contact tracing of all individuals who entered the country within 28 days prior to the mandatory screening should be planned and implemented immediately with an aim of increasing the chances of getting active cases, and possible transmission through such contacts. Continuous modeling of data is needed in order to cater for other factors which were not considered in this study such as the impact of mandatory quarantine, night curfews and suspension of international flights
A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation
Authors: Kuo Chuan-Yi , Liu Ying-Tung , Chen Tzu-Shan , Lam Chen-Fuh , Wu Ming-Cheng
Published: April 2020

Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.
The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST
Authors: Wu Na , Chen Yuhong , Yang Yaping , Sun Xinghuai
Published: April 2020

Background: To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA). Methods: 111 newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between month and corneal biomechanics． Results: The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (DA, β=-0.0015, P =0.016), the first applanation velocity (AV1, β=-0.0004, P =0.00058) decreased and the first applanation time (AT1, β=0.0089, P <0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P =0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P =0.00002) in NTG than in HTG after adjusting for confounding factors. Conclusions: Chronic use of PGA probably could influence the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.
Summary of perioperative calcium regulation therapy and analysis of related factors in the treatment of secondary hyperparathyroidism
Authors: Zhang XinSheng , zhang weibin , Dong Jia , Wu YunFei , Zheng Bin , Dai Jin , Ma Yan
Published: April 2020

Background：Retrospectively register the clinical data of secondary hyperparathyroidism（SHPT）patients who received surgical treatment, summarize the postoperative calcium regulation scheme in details and analyze statistically related factors for guiding clinical early intervention and evaluating prognosis.Methods: Review the clinical data of 136 patients with chronic renal failure in uremic stage from Jinzhou Central Hospital and the Second Affiliated Hospital of Dalian Medical University, who received dialysis treatment for a long time and finally diagnosed as secondary hyperparathyroidism, from Jan 2017 to Dec 2019, were accepted different operations to treat hyperparathyroidism, were given corresponding calcium regulation therapy to avoid serious complicationswere, and were divided into the observation group and the control group according to the postoperative calcium regulation time of ≤7days and > 7days, which is defined as the time from the day of operation until the day when the patients have stable blood calcium levels and no obvious discomfort symptoms.Results: The difference between the two groups was statistically significant (P<0.001); Compared with the control group, the observation group were elder(54.01±9.215; P<0.01), shorter preoperative dialysis time (5.05±2.855; P<0.01); significant difference in operation mode (P=0.026); positive preoperative oral calcium(c2=9.941, P=0.002), higher preoperative calcium value (t=4.795; P<0.001), lower preoperative Parathyroid Hormone(PTH) value (t=6.327; P<0.001), lower preoperative Alkaline phosphatase(ALP) value (t=3.527; P=0.001); Multivariate analysis showed that age, preoperative calcium value, preoperative PTH value and preoperative ALP value were independent risk factors for postoperative calcium regulation therapy. Those factors, Gender, preoperative dialysis mode, complications, preoperative Hemoglobin(HB) value, were not related to postoperative calcium regulation. There was no significant difference between the two groups (P>0.05).Conclusion: Effective postoperative calcium regulation can maintain a stable level of blood calcium in the patients with secondary hyperparathyroidism, so as to avoid the occurrence of severe hypocalcemia.
Markers for monitoring hydrogen peroxide resistance in the salmon louse, Lepeophtheirus salmonis
Authors: Agusti-Ridaura Celia , Bakke Marit Jørgensen , Helgesen Kari Olli , Sundaram Arvind YM , Bakke Sigrid Jørgensen , Kaur Kiranpreet , Horsberg Tor Einar
Published: April 2020

Background: Hydrogen peroxide (H2O2) is one of the delousing agents used to control sea lice infestations in salmonid aquaculture. However, some Lepeophtheirus salmonis populations have developed resistance towards H2O2. An increased gene expression and activity of catalase, an enzyme that breaks down H2O2, have been detected in resistant lice, being therefore introduced as a resistance marker in the salmon industry. In the present study the aim was to validate the use of catalase expression as a marker and to identify new markers related to H2O2 resistance in L. salmonis.Methods: A sensitive and an H2O2 resistant laboratory strain (P0 generation, not exposed to H2O2 for several years) were batch crossed to generate a cohort with a wide range of H2O2 sensitivities (F2 generation). F2 adult females were then exposed to H2O2 to separate sensitive and resistant individuals. Those F2 lice, the P0 lice and field-collected resistant lice (exposed to H2O2 in the field) were used in an RNA sequencing study.Results: Catalase was up-regulated in resistant lice exposed to H2O2 compared to sensitive lice. This was, however, not the case for unexposed resistant P0 lice. Several other genes were found differentially expressed between sensitive and resistant lice, but most of them seemed to be related to H2O2 exposure. However, five genes were consistently up- or down- regulated in the resistant lice independent of exposure history. The up-regulated genes were: one gene in the DNA polymerase family, one gene encoding a Nesprin-like protein and an unannotated gene encoding a small protein. The down-regulated genes encoded endoplasmic reticulum resident protein 29 and an aquaporin (Glp1_v2).Conclusions: Catalase expression seems to be induced by H2O2 exposure, since it was not up-regulated in unexposed resistant lice. This may pose a challenge for its use as a resistance marker. The five new genes associated with resistance are put forward as potential good, complementary markers. The most promising was Glp1_v2, an aquaglyceroporin that may serve as a passing channel for H2O2. Lower channel number can reduce the influx or distribution of H2O2 in the salmon louse, being directly involved in the resistance mechanism.
Does Socioeconomic Position Affect Knowledge of the Risk Factors and Awareness of the Warning Signs of Stroke in the WHO European Region? A Systematic Literature Review
Authors: Stack Katie , Robertson Wendy , Blackburn Clare
Published: April 2020

Background: Cerebrovascular accidents are one of the leading causes of death worldwide. People with a lower socioeconomic position (SEP) (i.e. with regards to education, income and occupation) are at a higher risk of having a stroke and have worse clinical outcomes compared to the general population. Good knowledge levels about stroke risk factors and warning signs are key to prolonging life and reducing health issues caused by stroke. This systematic review examined differences in knowledge of stroke risk factors and awareness of stroke warning signs with regards to SEP in the WHO European region.Methods: MEDLINE, Embase, Web of Science, PsycINFO and CINAHL were systematically searched to find articles looking at knowledge of risk factors and/or awareness of warning signs of stroke, with results broken down by SEP. A title and abstract screen, and, if appropriate, a full text screen, of these results was carried out, as well as screening reference lists of included studies. Only studies in the English language and those based in the WHO European region were included.Results: Screening identified 2,118 records. In the final review, 20 articles were included, with 67,309 study participants between them. Out of 17 studies that looked at stroke risk factors, 11 found increasing knowledge to be associated with higher SEP, four found no difference by SEP, one showed a mixed pattern and one outlier study found increasing knowledge of risk factors to be associated with a lower SEP. Out of 19 studies that looked at stroke warning signs or symptoms, 15 found there to be better awareness of warning signs with a higher SEP, three found there to be no difference, and the same outlier study found increasing knowledge of warning signs with a lower SEP. Studies that seemed to have a higher quality rating found increasing knowledge of stroke with a higher SEP.Conclusions: In the WHO European region, better knowledge of stroke risk factors and awareness of warning signs is associated with a higher SEP. Public health campaigns and educational interventions aiming to increase stroke awareness should be targeted at people with a lower SEP.
The Concept And Methods Of Community Participation In Animal And Human Disease Surveillance
Authors: Waziri Musa Ibrahim , Yunusa Kaltungo Bilkisu
Published: April 2020

Background: Animal health surveillance is essential to protecting public health, controlling animal diseases and accessing international animal trade with a view to ensuring food security. The practice of subsistent agriculture makes laboratory disease surveillance and statistics difficult or impracticable to implement. Many times, the information generated through conventional approach may not reflect true field situations. Therefore, animal health project interventions from conventional data may be difficult to implement. Community engagement, however, empowers and ensures lasting solutions to developmental challenges.Methods : Field experiences and a review of the origin, concepts, methods and tools of Participatory epidemiology (PE) in disease surveillance suggest their appropriate uses.Results : Community participation in animal and public health investigation, program design, implementation and monitoring is credited with ownership, acceptability and sustainability.Conclusion : This research highlights how and why participation is an essential component of a successful disease surveillance design and implementation. However, the success of any participatory program depends on understanding the bases and applications of the right tools.
Conflicto étnico, geopolítica e identidad: El caso de las comunidades Miskitas del Río Coco en Nicaragua
Authors: Kinloch Tijerino Frances
Published: April 2020

En la frontera entre Nicaragua y Honduras se encuentra el río Coco o Wangli: en sus riberas dispersos en pequeñas comunidades a lo largo del río habitan los miskitos, grupo indígena ingnorado hasta 1980, cuando sus territorios se vieron invadidos y envueltos en un conflicto étnico en el que influyó en forma directa una lucha geopolítica entre varias potencias mundiales.
VS-5584 Inhibits Human Osteosarcoma Cells Growth by Induction of G1- phase Arrest through Regulating PI3K/mTOR and MAPK Pathways
Authors: Sun Jing-Yi , Hou Ya-Jun , Cui Hai-Juan , Zhang Cheng , Yang Ming-Feng , Wang Feng-Ze , Sun Zheng , Fan Cun-Dong , Sun Bao-Liang , Oh Jin Rok
Published: April 2020

Background:

Activation of PI3K/mTOR signaling pathway plays key role in the
progression of human osteosarcoma. Studies have confirmed that VS-5584 was a
novel inhibitor of PI3K/mTOR pathway, and displayed potential anticancer activity.

Objective:

To explore the anticancer effect and underlying mechanism of VS-5584 against the
growth of human osteosarcoma cells.

Methods:

U2OS and MG-63 human osteosarcoma cells were cultured and the cytotoxicity, cell
apoptosis in VS-5584-treated cells were explored by the CCK8 assay, flow cytometric analysis and
western blot. Cell migration and tube formation were also employed to examine the anticancer potential.

Results:

The results showed that VS-5584 treatment dose-dependently inhibited the growth of U2OS
and MG-63 cells by induction of G1-phase arrest through regulating p21, p27, Cyclin B1 and Cdc2.
Further investigation revealed that VS-5584 treatment effectively inhibited the PI3K/mTOR signaling
pathway and triggered MAPK phosphorylation. Moreover, VS-5584 treatment dramatically suppressed
cell migration and tube formation of HUVECs, followed by the down-regulation of HIF-1α
and VEGF.

Conclusion:

Our findings validated that VS-5584 may be a promising anticancer agent with potential
application in the chemotherapy and chemoprevention of human osteosarcoma.