bluuebunny/crossref_metadata_2025 huggingface dataset:
Setting Health Care Services Tariffs in Iran: Half a Century Quest for a Window of Opportunity
Authors: Doshmangir Leila , Rashidian Arash , Kouhi Farhad , Gordeev Vladimir S
Published: June 2020

Background: The process of medical tariffs setting in Iran remains to be a contentious issue and is heavily criticized by many stakeholders. This paper explores the experience of setting health care services tariffs in the Iranian health care system over the last five decades. Methods: We analyzed data collected through literature review and reviews of the official documents developed at the various levels of the Iranian health system using inductive and deductive content analysis. Twenty-two face-to-face semi-structured interviews supplemented the analysis. Data were analysed and interpreted using 'policy triangle' and 'garbage can' models.Results: Our comprehensive review of changes in the medical tariff setting provides valuable lessons for major stakeholders. Most changes were implemented in a sporadic, inadequate, and a non-evidence-based manner. Disparities in tariffs between public and private sectors continue to exist. Lack of clarity in tariffs setting mechanisms and its process makes negotiations between various stakeholders difficult and can potentially become a source of a corrupt income. Such clarity can be achieved by using fair and technically sound tariffs. Technical aspects of tariff setting should be separated from the political negotiations over the overall payment to the medical professionals. Transparency regarding a conflict of interest and establishing punitive measures against those violating the rules could help improving trust in the doctor-patient relationship. Conclusion: Use of evidence-informed models and methods in medical tariff setting could help to strike the right balance in the process of health care services provision to address health system objectives. A sensitive application of policy models can offer significant insights into the nature of medical tariff setting and highlight existing constraints and opportunities. This study generates lessons learned in tariffs setting, particularly for low- and middle-income countries.
Forecasting the long-term trend of COVID-19 epidemic using a dynamic model
Authors: Sun Jichao , Chen Xi , Zhang Ziheng , Lai Shengzhang , Zhao Bo , Liu Hualuo , Zhao Ruihui , Ng Alexander , Zheng Yefeng
Published: June 2020

The current outbreak of coronavirus disease 2019 (COVID-19) has recently been declared as a pandemic and spread over 200 countries and territories. Forecasting the long-term trend of the COVID-19 epidemic can help health authorities determine the transmission characteristics of the virus and take appropriate prevention and control strategies beforehand. This protocol introduced a new model named Dynamic-Susceptible-Exposed-Infective-Quarantined (D-SEIQ), by making appropriate modifications of the Susceptible-Exposed-Infective-Recovered (SEIR) model and integrating machine learning based parameter optimization under epidemiological rational constraints. The model could be applied to forecast the long-term trend of the current COVID-19 epidemic. The parameters obtained by the model could help assess the effectiveness of prevention and intervention strategies on epidemic control in different countries.
CARTA Fellows’ Scientific Contribution to the African Public and Population Health Research Agenda (2011 to 2018)
Authors: Igumbor Jude , Bosire Edna N , Basera Tariro , Dieudonn Uwizeye , Fayehun Funke , Wao Hesborn , Ajuwon Ademola , Otukpa Emmanuel , Karimi Florah , Conco Daphney , Gitau Evelyn , Fonn Sharon
Published: June 2020

Background: Since its inception in 2009, the Consortium for Advanced Research Training in Africa (CARTA) program has focused on strengthening the capacity of nine African universities and four research centres to produce skilled researchers and scholars able to improve public and population health on the continent. This study describes the alignment between CARTA-supported doctoral topics and publications with the priorities articulated by the African public and population health research agenda. Methods: We reviewed the output from CARTA PhD fellows between 2011 and 2018 to establish the volume and scope of the publications, and the degree to which the research focus coincided with the SDGs, World Bank, and African Development Bank research priority areas. We identified nine key priority areas into which the topics were classified.Results: In total, 140 CARTA fellows published 806 articles in peer-reviewed journals over the 8 years up to 2018. All the publications considered in this paper had authors affiliated with African universities, 90% of the publications had an African university first author and 41% of the papers have CARTA fellows as the first author. The publications are available in over 6300 online versions and have been cited in over 5500 other publications. About 69% of the published papers addressed the nine African public and population health research agenda and SDG priority areas. Infectious diseases topped the list of publications (26.8%), followed by the health system and policy research (17.6%), maternal and child health (14.7%), sexual and reproductive health (14.3%). Conclusions and recommendations: Investments by CARTA in supporting doctoral studies provides fellows with sufficient training and skills to publish their research in fields of public and population health. The number of publications is understandably uneven across Africa’s public and population priority areas. Even while low in number, fellows are publishing in areas such as non-communicable disease, health financing, neglected tropical diseases and environmental health. Violence and injury is perhaps underrepresented. There is need to keep developing research capacity in partner institutions with low research output by training more PhDs in such institutions and by facilitating enabling environments for research.
Recognition and Stigma of Prescription Drug Abuse Disorder: Personal and Community Determinants
Authors: Shupp Robert , Loveridge Scott , Skidmore Mark , Green Brandn , Albrecht Don
Published: June 2020

Background: Prescription drug abuse (PDA) disorders continue to contribute to the current American opioid crisis. Within this context, our study seeks to improve understanding about stigma associated with, and symptom recognition of, prescription drug abuse. Aims: Model the stigma and symptom recognition of PDA in the general population. Methods: A randomized, nation-wide, online, vignette-focused survey of the general public (N = 631) was implemented with an oversample for rural counties. Logit estimation was used for analysis, with regional and county-level sociodemographic variables as controls. Results: Individual respondents that self-identify as having or having had “a prescription drug abuse issue” were less likely to correctly identify the condition and were 4 times more likely to exhibit stigma. Male respondents were approximately half as likely to correctly identify PDA as female respondents while older respondents (55+) were more likely to correctly identify PDA, relative to those aged 35-54. Being both male and younger was associated with slightly more stigma, in that they were less likely to disagree with the stigma statement. Conclusions: In light of the continued risks that individuals with PDA behaviors face in potentially transitioning to illicit opioid use, the findings of this survey suggested a continued need for public education and outreach. Of particular note is the perspective of those who have self-identified with the condition, as this population faces the largest risks of adverse health outcomes from illicit drug use within the survey respondents.
Verteporfin Inhibits Cell Proliferation and Induces Apoptosis in Different Subtypes of Breast Cancer Cell Lines Without Light Activation
Authors: Wei changran , Li xiangqi
Published: June 2020

Background: Breast cancer (BC) can be separated into five subtypes, including Lumina1A, Lumina1B, HER-2 overexpression, Basal-like and Normal breast-like subtype according to the differently expressed genes in breast cancer tissue.. The Hippo signaling pathway plays an indispensable role in BC. The YAP1 gene is a terminal effector of Hippo pathway, and hyperactivation of YAP mediates tumorigenesis. As an inhibitor of YAP, non-photoactivated verteporfin (VP) can inhibit YAP-mediated tumor proliferation and angiogenesis by eliminating its interaction with TEAD. This study set out to determine the effect and molecular mechanisms of VP-mediated inhibition of YAP in different subtypes of BC.Methods: Luminal A, Luminal B and Basal-like BC cells were cultivated in vitro in order to study effect of VP on proliferation and apoptosis on these three molecular BC subtypes. Results: Our experimental results show that VP inhibits cell proliferation, YAP-TEAD interaction and its downstream target expression. VP also induces tumor cell apoptosis, and promotes the cleavage of Caspase-9 and PARP in various molecular subtypes of BC cells. Conclusion: These findings provide a basis for VP as a potential anti-tumor therapeutic for BC by targeting the Hippo pathway effector YAP.
Impact of Breath-Hold Level on Positional Error Aligned by Stent/Lipiodol in Hepatobiliary Radiotherapy with Breath-Hold Respiratory Control
Authors: Huang Tzu-Jie , Tien Yun , Wu Jian-Kuen , Huang Wen-Tao , Cheng Jason Chia-Hsien
Published: June 2020

Background: Respiratory motion management with breath hold for patients with hepatobiliary cancers remain a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated with positional errors under breath-hold control.Methods: Spirometric motion management system (SDX) for breath holds was used in 44 patients with hepatobiliary tumor. Among them, 28 patients had a stent or embolized materials (lipiodol) as alignment markers. Cone-beam computed tomography (CBCT) and kV-orthogonal images were compared for accuracy between different alignment references. Breath-hold level (BHL) was practiced, and BHL variation (ΔBHL) was defined as the standard deviation in differences between actual BHLs and baseline BHL. Mean BHL, ΔBHL, and body-related factors were analyzed for the association with positional errors.Results: Using the reference CBCT, the correlations of positional errors were significantly higher in those with stent/lipiodol than when the vertebral bone was used for alignment in three dimensions. Patients with mean BHL >1.4 L were significantly taller (167.6 cm vs. 161.6 cm, p=0.03) and heavier (67.1 kg vs. 57.4 kg, p=0.02), and had different positional error in the craniocaudal direction (-0.26 cm [caudally] vs. +0.09 cm [cranially], p=0.01) than those with mean BHL <1.4 L. Positional errors were similar for patients with ΔBHL<0.03 L and >0.03 L.Conclusion: Under rigorous breath-hold respiratory control, BHL correlated with body weight and height. With more accurate alignment reference by stent/lipiodol, actual BHL but not breath-hold variation was associated with craniocaudal positional errors.
Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: A mixed methods approach
Authors: Henriksen André , Sand Anne-Sofie , Deraas Trygve , Grimsgaard Sameline , Hartvigsen Gunnar , Hopstock Laila
Published: June 2020

Background: Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for participant monitoring in clinical research. Methods: Sixteen participants aged 55-74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk, were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by six months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investigate how individual wear-time was linked to participant responses. Results: From one year of tracking, mean number of valid wear days were 292 (SD=86), i.e. 80%. The Polar M430 provides acceptable measurements for total energy expenditure. Motivations for increased wear time were that participants were asked to wear it, and the ability to track PA progress. Perceived usefulness included time keeping, heart rate- and sleep tracking, becoming more conscious about day-to-day activity, and improved understanding of activity types effectiveness. Sources of AT annoyance were measurement inaccuracies and limited instruction for use. Suggestions for improvement were that the AT was big, unattractive, and too complicated to use.Conclusions: Adherence to wearing a consumer-based AT was high. Results indicate that it is feasible to use a consumer-based AT to measure PA over a longer period. Potential success factors for increased wear time includes adequate instruction for AT use, allowing participant to choose between different AT designs, and using trackers with accurate measurements. To identify accurate trackers, AT validation studies in the target cohort may be needed. Trial registration: U.S. National Library of Medicine, Clinical Trial registry: NCT03807323; Registered 16 September 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03807323
Inhibition of Notch pathway enhances the anti-tumor effect of docetaxel in prostate cancer stem-like cells
Authors: Wang Lei , Zi Hao , Luo Yi , Liu Tongzu , Zheng Hang , Xie Conghua , Wang Xinghuan , Huang Xing
Published: June 2020

Background: Prostate cancer stem-like cells (PCSCs) likely participate in tumor progression and recurrence, and demonstrate resistance to chemotherapy. The Notch pathway plays a role in the maintenance of the stemness in PCSCs. This study aimed to investigate the efficacy of Notch signaling inhibition as an adjuvant to docetaxel (DOX) in PCSCs.Methods: PCSCs derived from PC-3 cell line were examined for Notch-1 expression. The effect of Notch inhibition on response to DOX was evaluated in PCSCs in vitro and in murine models using a γ-secretase inhibitor (GSI), PF-03084014. Impacts on cell proliferation, apoptosis, cell cycle, and sphere formation were evaluated.Results: PC-3 PCSCs expressed elevated Notch-1 mRNA compared with PC-3 parental cells. The combination of GSI with DOX promoted DOX induced cell growth inhibition, apoptosis, cell cycle arrest, and sphere formation in PCSCs. In nude mice bearing PC-3 PCSCs-derived tumors, the combination of GSI and DOX reduced the tumor growth, which was associated with the decreased Notch-1 expression in tumor tissues.Conclusions: These results reveal that inhibition of Notch pathway enhances the anti-tumor effect of DOX in PC-3 PCSCs, and suggest that Notch inhibition may have clinical benefits in targeting PCSCs.
A comparison of Passive Surveillance and Active Cluster-Based Surveillance for Dengue Fever in southern coastal Ecuador
Authors: Vitale Melissa , Lupone Christina , Kenneson-Adams Aileen , Ochoa Robinson Jaramillo , Ordoñez Tania , Beltran-Ayala Efráin , Endy Timothy P. , Rosenbaum Paula F. , Stewart-Ibarra Anna M.
Published: June 2020

Background: Dengue is a major emerging infectious disease, endemic throughout the tropics and subtropics, with approximately 2.5 billion people at risk globally. Active (AS) and passive surveillance (PS), when combined, can improve our understanding of dengue’s complex disease dynamics to guide effective, targeted public health interventions. The objective of this study was to compare findings from the Ministry of Health (MoH) PS to a prospective AS arbovirus research study in Machala, Ecuador in 2014 and 2015[P1] . Methods: Dengue cases in the PS system were compared to laboratory confirmed acute dengue illness cases that entered the AS study during the study period. Variables of interest included age, class, and sex. Outbreak detection curves by epidemiologic week, overall cumulative incidence and age-specific incidence proportions were calculated. Descriptive statistics were tabulated for all variables of interest. Chi-square tests were performed to compare demographic characteristics between the AS and PS data sets in 2014 and 2015. Results: 177 and 245 cases were identified from 1/1/2014 to 12/31/2015 by PS and AS, respectively; nine cases appeared in both systems. AS identified a greater number of laboratory-confirmed cases in 2014, accounting for more than 60% of dengue cases in the study area. In 2015, the opposite trend was observed with PS identifying 60% of the dengue cases in the region. Peak transmission time, as noted by AS and PS was similar in 2014 whereas earlier detection was observed by AS in 2015.Younger patients were more frequently identified by PS, while older patients were identified more frequently by AS. The cumulative incidence proportion for laboratory confirmed dengue illness reported via PS to the MoH was 4.12 cases per 10,000 residents in 2014, and 2.21 cases per 10,000 residents in 2015.Conclusions: Each surveillance system captured distinct demographic subgroups within the Machala population, possibly due to differences in healthcare seeking behaviors, access to care, emerging threats of other viruses transmitted by the same mosquito vector and/or differences in clinical presentation. Integrating AS with pre-existing PS can aid in identifying additional cases in previously under diagnosed subpopulations, improving our understanding of disease dynamics, and facilitating the implementation of timely public health interventions.
Efficacy of serum miRNA test as a non-invasive method to diagnose nonalcoholic steatohepatitis: a systematic review and meta-analysis.
Authors: Xin Shengliang , Zhan Qiao , Chen Xiaofan , Xu Jinghang , Yu Yanyan
Published: June 2020

1. Background: Nonalcoholic steatohepatitis (NASH) is a key turning point during the progression of nonalcoholic fatty liver disease (NAFLD). Recent studies have shown that serum miRNA tests may be effective in the diagnosis of NAFLD. We conducted a meta-analysis to assess the evidence for the diagnostic efficacy of serum miRNAs in patients with NAFLD and its subtype, NASH, in particular. 2. Methods: After a systematic review, sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) were pooled to determine the efficacy of serum miRNA test for the diagnosis of NAFLD and NASH. Clinical utility was evaluated by Fagan’s nomogram and likelihood ratio scattergram. Heterogeneity was evaluated by subgroup analysis and meta-regression. Publication bias was detected by Deeks’ funnel plot. 3. Results: We included 27 trials containing 1775 NAFLD patients (including simple steatosis and NASH) and 586 NASH patients. For NAFLD vs NASH, the pooled sensitivity, specificity, and AUROC were (0.71 vs. 0.74), (0.76 vs. 0.85) and (0.80 vs. 0.86), respectively. Serum miRNA had high accuracy for distinguishing NASH from simple steatosis, with an AUROC of 0.91. Among the most commonly studied serum miRNAs , miRNA-34a showed moderate diagnostic accuracy for NAFLD and the lowest heterogeneity (sensitivity I 2 = 5.73%, specificity I 2 = 33.16%, AUROC = 0.85). According to subgroup analysis and meta-regression, a lower BMI ( < 30 kg/m 2 ) might be a crucial source of heterogeneity. 4.Conclusions: As a novel non-invasive method, serum miRNA test exhibited robust diagnostic efficacy for NASH. Among these well-studied miRNAs, miRNA-34a was more available for diagnosis. Diagnosis of NAFLD by serum miRNA is more likely to be accurate in patients with BMI ≥ 30kg/m 2 .
Anti-NMDAR encephalitis induced in mice by active immunization with a peptide from amino-terminal domain of the GluN1 subunit
Authors: Ding Yuewen , Zhou Zheye , Chen Jinyu , Peng Yu , Wang Haitao , Qiu Wei , Xie Wei , Zhang Jun , wang honghao
Published: June 2020

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently discovered autoimmune syndrome associated with psychosis, dyskinesia, and seizures. However, the underlying mechanisms of this disease remain unclear, in part because of a lack of suitable animal models. This study describes a novel mouse model of anti-NMDAR encephalitis that was induced by active immunization against NMDARs using amino-terminal domain peptides. After 12 weeks of immunization, the mice showed significant behavioral disorders and memory loss. Furthermore, antibodies from the cerebrospinal fluid of immunized mice lowered the surface NMDAR cluster density in hippocampal neurons. Immunization also impaired long-term potentiation at Schaffer collateral–CA1 synapses and reduced NMDAR-induced calcium influx. This novel mouse model may allow further research into the pathogenesis of anti-NMDAR encephalitis and aid in the development of new therapies for this disease.
The underlying mechanism of partial anterior cruciate ligament injuries to the meniscus degeneration of knee joint in rabbit models
Authors: Wang Dalin , Wang Zhe , Li Mingcheng , Xu Songbao
Published: June 2020

Background: The diagnosis, treatment and efficacy evaluation of anterior cruciate ligament (ACL) partial rupture remains controversial. This research aims to investigate the underlying mechanism of partial ACL injuries to the meniscus degeneration in the rabbit knee. Methods: Sixty New Zealand, white rabbits were randomly divided into three groups including an experimental group, a sham group (n=6) and and a blank control group (n=6). The experimental group is composed of an anteromedial bundle (AMB) rupture group (n=24), a posterolateral bundle (PLB) rupture group (n=24). Rabbits in the experimental group were subjected to right hind limbs knee surgery to induce ACL part injury under the arthroscopy. Finally, eight rabbits including 6 in the model group and 2 in the control group were sampled randomly on the second, fourth and eighth weeks respectively. We observed the typical form of the meniscus through HE staining. Expressions of inflammatory factors including interleukin-1β (IL-1β) and IL-17 in the knee joint fluid were determined by means of an ELISA. Analysis of the mRNA expressions of matrix metalloproteinases-13(MMP-13) was performed to evaluate the inflammatory mediators in the pathogenesis of the meniscus. Results: HE staining results showed that the surface was rough and the tissues were loose displaying collagen fibers of varying thickness. Both IL-1β and IL-17 in the synovial fluid, and the positive rate of MMP-13 in addition to MMP-13 mRNA showed a demonstrable increase treads from the 2nd to the 8th week. The significant difference was found (P<0.05) compared to the control group. Conclusion: We conclude that the elevated levels of IL-1β and IL-17, along with increased MMP13 expression, resulted in meniscus degradation in the rabbit knee joint model with partial ACL injury.
Using CT texture analysis to differentiate between peripheral lung cancer and pulmonary inflammatory pseudotumor
Authors: Liu Chenlu , Ma Changsheng , Duan Jinghao , Qiu Qingtao , Guo Yanluan , Zhang Zhenhua , Yin Yong
Published: June 2020

Background: This study is to distinguish peripheral lung cancer and pulmonary inflammatory pseudotumor using CT-radiomics features extracted from PET/CT images. Methods: In this study, the standard 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18 F-FDG PET/CT) images of 21 patients with pulmonary inflammatory pseudotumor (PIPT) and 21 patients with peripheral lung cancer were retrospectively collected. The dataset was used to extract CT-radiomics features from regions of interest (ROI), The intra-class correlation coefficient (ICC) was used to screen the robust feature from all the radiomic features. Using, then, statistical methods to screen CT-radiomics features, which could distinguish peripheral lung cancer and PIPT. And the ability of radiomics features distinguished peripheral lung cancer and PIPT was estimated by receiver operating characteristic (ROC) curve and compared by the Delong test. Results: A total of 435 radiomics features were extracted, of which 361 features showed relatively good repeatability (ICC³0.6). 20 features showed the ability to distinguish peripheral lung cancer from PIPT. these features were seen in 14 of 330 Gray-Level Co-occurrence Matrix features, 1 of 49 Intensity Histogram features, 5 of 18 Shape features. The area under the curves(AUC) of these features were 0.731 0.075, 0.717, 0.748 0.038, respectively. The P values of statistical differences among ROC were 0.0499 (F9, F20), 0.0472 (F10, F11) and 0.0145 (F11, Mean4). The discrimination ability of forming new features (Parent Features) after averaging the features extracted at different angles and distances was moderate compared to the previous features(Child features). Conclusion: Radiomics features extracted from non-contrast CT based on PET/CT images can help distinguish peripheral lung cancer and PIPT.
Patterns of food parenting practices regarding junk food and sugary drinks among parent-child dyads
Authors: Thomson Jessica , Hennessy Erin , Landry Alicia , Goodman Melissa
Published: June 2020

Background: Children’s food preference and intake patterns are affected by parental child feeding practices. The objective of this study was to determine patterns of food parenting practices regarding junk food and sugary drinks (JS) and to investigate their associations with demographic characteristics and dietary intake in a large cohort of parents and their children (12-17 years). Methods: Dyadic survey data from the cross-sectional, internet-based Family Life, Activity, Sun, Health, and Eating Study, conducted in 2014, were analyzed using latent class analysis to identify patterns of use for six JS parenting practices – negative emotions, restriction, monitoring, availability, modeling, and child involvement – based on both parent and child report. Model covariates included self-reported parent sex, body mass index, added sugars intake, and legitimacy of parental authority; and self-reported child age, sex, body mass index percentile, added sugars intake, and legitimacy of parental authority. Results: Based on 1,657 parent-child dyads, five latent classes were identified – Complete Influencers (28%), Indifferent Influencers (21%), Negative Influencers (20%), Minimal Influencers (18%), and Disagreeing Influencers (13%). Compared to older child dyads, younger child dyads had 79% and 63% lower odds of belonging to Indifferent and Minimal Influencers versus Complete Influencers. Odds of belonging to Indifferent and Negative Influencers were 4% and 5% higher for every teaspoon increase in parent added sugars intake while odds for Minimal Influencers were 6% lower for every teaspoon increase in child added sugars intake versus Complete Influencers. Dyads with low compared to high parental and child agreement with legitimacy of parental authority regarding JS had between 2 and 26 times the odds of belonging to one of the other classes versus Complete Influencers. Conclusions: The study findings suggest that parents utilize distinct patterns of feeding practices related to JS ranging from use of many practices, use of some practices, to low use of any practice, with differential associations with parent and child intakes of added sugars. Counseling or intervening with parents to use a mix of structure practices to positively influence their child’s and possibly their own intake of sugary snacks and drinks may prove more efficacious than use of coercive control practices.
Anti-inflammatory effects of rosuvastatin treatment in coronary artery ectasia patients in different age groups
Authors: Fan Chenghui , Hao Ying , Liu Yonghua , Li Xiaolin , Huang Zhenhao , Luo Yu , Li Ruilin
Published: June 2020

Background: Coronary artery ectasia (CAE) is an angiographic finding of abnormal coronary dilatation. The role of inflammation in atherosclerosis is becoming increasingly well known. This study investigated the relationship between CAE and serum levels of high-sensitivity C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) to test our hypothesis that patient age is associated with the efficacy of anti-inflammatory therapy for CAE. Methods: We conducted a prospective analysis of 217 patients with CAE treated at the Department of Cardiology, Shanghai East Hospital, Shanghai East Hospital (Ji'an Campus), and Cardiovascular Medicine of Baoshan People’s Hospital of Yunnan Province, from January 1, 2015 to July 30, 2019. Baseline data of patients, including sex, age, hypertension, hyperlipidemia, and diabetes, were collected from patient medical records. Study participants were grouped by age as follows: CAE-A (age ≤50 years), CAE-B (50 years 70). Additionally, there was a normal control (NC) group with normal coronary arteries.Results: All patients received oral rosuvastatin therapy (10 mg, QN quaque nocte) when they were diagnosed with CAE and maintained good follow-up, with a loss rate of 0.0% at the 6-month follow-up. The NC group (n = 73, with normal coronary arteries) received regular symptom-relieving treatments and rosuvastatin therapy. Among these four groups, the inflammatory markers were significantly higher in patients with CAE than in the NCs (p<0.01). Logistic regression analysis showed that Hs-CRP (OR=1.782, 95% CI: 1.124-2.014, P=0.021) and IL-6 (OR=1.584, 95% CI: 1.112-1.986, P=0.030) were independent predictors of CAE. The inflammatory markers in the CAE-A group were higher than those in the CAE-B group, which were higher than those in the CAE-C group. Follow-up after 6 months of rosuvastatin therapy showed a significantly greater reduction in Hs-CRP and IL-6 levels in the CAE-A group than in the CAE-B group, which, again, were higher than those in the CAE-C group. Conclusions: Anti-inflammatory therapy using rosuvastatin was more effective in younger CAE patients, indicating the need for early statin therapy in CAE patients.
Lay perspectives on social distancing and other official recommendations and regulations in the time of COVID-19: a qualitative study of social media posts
Authors: Ölcer Sabahat , Yilmaz-Aslan Yüce , Brzoska Patrick
Published: June 2020

Background: COVID-19 caused by a new form of coronavirus (SARS-CoV-2) first appeared in China end of 2019 and quickly spread to all counties of the world. To slow down the spread of the virus and to limit the pressure on the health care systems, different regulations and recommendations have been implemented by authorities, comprising amongst others the closure of all entertainment venues and social distancing. These measures have received mixed reactions, particularly from young individuals, with many not following available advice. Drawing on the information in social media discussion forums, the present study explores the reasons why people ignore the orders and recommendations of the authorities and why the authorities are unable to produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak. Methods: Three open-access social media forums (Reddit, Twitter, and YouTube comments) were systematically searched with respect to COVID-19-related beliefs, attitudes, and behaviours of individuals. The data was retrieved in the first three weeks of March 2020. Qualitative document analysis and qualitative content analysis were used as the methodical approach. The data was reviewed by all authors and jointly interpreted to minimise inconsistencies.Results: The study reveals that reasons such as information pollution on social media, the persistence of uncertainty about the rapidly spreading virus, the impact of the social environment on the individual, and fear of unemployment associated with inequality in the distribution of income lead people to ignore the orders and recommendations of the authorities. The findings suggest that government representatives and politicians could not produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak, due to not building trust among the public and taking concrete economic steps to satisfy them.Conclusion: In uncertain crises, transparency in the presentation of information and government policies emerge as influential determinants in creating social susceptibility and solidarity. The differences between social classes constitute one of the important factors that affect the decision-making mechanisms of individuals in determining the necessary steps to be undertaken in times of crisis.
Rubidium chloride modulated the intestinal microbiota community in mice
Authors: Chen Qian , He Zhiguo , Zhuo Yuting , Li Shuzhen , Yang Wenjing , Hu Liang , Zhong Hui
Published: June 2020

Background
The intestinal microbiota plays an important role in host health. Although rubidium (Rb) has been used to study for depression and cancers, the interaction between intestinal microbial commensals and Rb is still unexplored. To gain the knowledge of the relationship between Rb and intestinal microbes, 51 mice receiving RbCl-based treatment and 13 untreated mice were evaluated of their characteristics and bacterial microbiome changes.
Results
The 16S ribosomal RNA gene sequencing of feces showed RbCl generally maintained the microbial community diversity, while the shifts in gut microbial composition were apparent after RbCl exposure for the first time. RbCl significantly enhanced the abundances of Rikenellaceae, Alistipes, Clostridium XlVa and sulfate-reducing bacteria including Deltaproteobacteria, Desulfovibrionales, Desulfovibrionaceae and Desulfovibrio. While, RbCl significantly inhibited the abundances of Tenericutes, Mollicutes, Anaeroplasmatales, Anaeroplasmataceae and Anaeroplasma lineages. Besides, with regarding to the composition of archaea, RbCl significantly enhanced the abundances of Crenarchaeota, Thermoprotei, Sulfolobales, Sulfolobaceae and Sulfolobus lineages.
Conclusions
These results revealed that enrichments of Clostridium XlVa, Alistipes and sulfate-reducing bacteria could act on brain-gut-microbiota axis by affecting serotonergic system and immune system. Therefore, it was likely that RbCl would have beneficial anti-effects on depression and cancers by modifying brain-gut-microbiota axis.
Psychological Investigation on Pregnant Women during the Outbreak of COVID-19
Authors: Chen Shaoqi , Zhuang Jiamian , Chen Qingzi , Tan Xuerui
Published: June 2020

Background COVID-19(Corona Virus Disease 2019) outbreaks around the world and is highly infectious, which may cause people prone to anxiety and depression. As a particular group, pregnant women need more attention. The aim of study is to investigate the mental health status of pregnant women during the outbreak of COVID-19, and analyze factors affecting the mental health status of pregnant women.Methods Using a self-designed questionnaire, self-rated anxiety scale(SAS), self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women during the outbreak of COVID-19.Results Compared with general adults in some regions of China, the scores of SAS and SDS were both significantly higher in pregnant women during the outbreak of COVID-19 (P < 0.05). The results of multivariate regression analysis unveiled that age, levels of education, and duration of pregnancy were all factors influencing pregnant women’s psychological status. In terms of psychological problems, compared with pregnant women aged < 30 years old, the risk of psychological problems in pregnant women aged ≥ 30 years old was 0.646 times (95% confidence interval (CI): 0.486–0.858). Moreover, compared with women with a level of high school or below, the risk of psychological abnormalities in women with a level of junior college degree or above was 0.551 times (95% CI: 0.416–0.731). Compared with women during the first trimester, the risk of psychological problems in women during the mid-trimester was 0.543 times (95% CI: 0.398–0.739). In addition, compared with women during the mid-trimester, the risk of psychological problems in women during the last trimester was 0.636 times (95% CI: 0.466–0.867).Conclusions During the outbreak of COVID-19, pregnant women are prone to anxiety or depression, highlighting the necessity of further attention on those subjects. It is of great significance to provide on-time psychological intervention and psychological counseling for pregnant women with poor mental health.
Preliminary experience with tacrolimus in managing Henoch-Schönlein purpura featuring extrarenal symptoms refractory to conventional therapy
Authors: Chen Yan , Bai Haitao , Yang Yang , Lian Zhulan
Published: June 2020

Background

Henoch-Schönlein purpura (HSP) is the commonest vasculitis of childhood, affecting multiple organ systems. The extrarenal manifestations are prominent in some HSP cases, for which no standard treatment is available. It is interesting to examine the value of tacrolimus in such cases.
Findings

Seventeen children received tacrolimus to manage their refractory extrarenal symptoms of HSP in an open-label prospective study. Tacrolimus was administered at daily dose of 0.05–0.15 mg/kg. Tacrolimus was effective in all cases after treatment for 7–21 days. Tacrolimus treatment resulted in complete resolution of extrarenal symptoms in 15 cases, and partial resolution in the remaining 2 cases. During follow-up, skin purpura reoccurred in 2 cases, abdominal pain and loss of follow-up in 1 case each. Drug-related adverse reaction was not observed in any case. Abnormal renal function test was identified in 7 patients by urinary screening tests before tacrolimus therapy, 4 of them received renal biopsy. Only one patient showed evidence of renal impairment during follow-up.
Conclusions

Tacrolimus works quickly without drug-related adverse reaction in managing the HSP patients featuring recurrent extrarenal symptoms. Our preliminary experience suggests good clinical efficacy and safety of tacrolimus in such off-label use.
Medication-related problems among hospitalized pregnant women in a tertiary teaching hospital in Ethiopia: A prospective observational study
Authors: AHMED SEID MUSSA , Sundby Johanne , Aragaw Yesuf Ahmed , Nordeng Hedvig
Published: June 2020

Background
Studies on medication-related problems (MRPs) among pregnant women are scarce, despite the potential consequences for both mother and child. This study aimed to describe the prevalence, clinical significance, and risk factors for MRPs among hospitalized pregnant or postpartum women at Jimma University Medical Centre (JUMC) in Ethiopia.
Methods
A prospective follow-up and clinical audit of 1,117 hospitalized pregnant or postpartum women in the maternity and gynaecology wards at JUMC was carried out between February and June 2017. Patients were followed throughout their stay in the hospital to assess the presence and development of MRPs. Pre-tested data extraction form and an interview-guided structured questionnaire were used to collect data. Descriptive statistics were used to describe MRPs. Logistic regression analysis was used to identify factors associated with MRPs.
Results
One or more MRPs occurred among 323 (28.9%) study participants, mostly in relation to lack of iron supplementation. A total of 278 (70.6%) of all MRPs were considered to be of moderate to high clinical significance. Nulliparous women were more likely to experience MRPs than their counterparts (adjusted OR 1.82; 95% CI 1.23, 2.69). When excluding MRPs due to iron from the analysis, nulliparous women (adjusted OR 1.99; 95% CI 1.22, 3.24) and previous medication use were significantly associated with experiencing an MRP (adjusted OR 2.38; 95% CI 1.24, 4.56).
Conclusions
Nearly 3 out of 10 hospitalized pregnant women at JUMC had one or more MRPs. The need for additional iron therapy was by far the most common type of MRP. Improved adherence to guidelines on iron supplementation are required. Multidisciplinary approaches including physicians, nurses, and clinical pharmacists in the maternity and gynaecology wards could possibly prevent MRPs and promote patient safety for women and children.
Integrated analysis of the functions and prognostic values of RNA binding proteins in colon adenocarcinoma
Authors: Liu Xinhong , Tan Fang , Long Xingyao , Yi Ruokun , Yang Dingyi , Zhao Xin
Published: June 2020

Background

RNA binding proteins (RBPs) play an important role in a variety of cancers. However, the role of RBPs in colorectal adenocarcinoma (COAD) has not been studied. Integrated analysis of RBPs will provide a better understanding of disease genesis and new insights into COAD treatment.
Methods

The gene expression data and corresponding clinical information for COAD were downloaded from The Cancer Genome Atlas (TCGA) database. Univariate Cox regression analysis was used to screen for RBPs associated with COAD recurrence, and multivariate Cox proportional hazards regression analyses were used to identify genes that were associated with COAD recurrence. A nomogram was constructed to predict the recurrence of COAD, and a receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of the prediction models. The Human Protein Atlas database was used in prediction models to confirm the expression of key genes in COAD patients.
Result

A total of 177 differentially expressed RBPs was obtained, comprising 123 upregulated and 54 downregulated. GO and KEGG enrichment analysis showed that the differentially expressed RBPs were mainly related to mRNA metabolism, RNA processing and translation regulation. Seven RBP genes (TDRD6, POP1, TDRD7, PPARGC1A, LIN28B, LRRFIP2 and PNLDC1) were identified as prognosis-associated genes and were used to construct the prognostic model.
Conclusion

We constructed a COAD prognostic model through bioinformatics analysis, which indicated that prognostic model RBPs have a potential role in the diagnosis and prognosis of COAD. Moreover, the nomogram can effectively predict the 1-year, 3-year, and 5-year survival rate for COAD patients.
Association of Neutrophil-to-Lymphocyte Ratio, Neutrophil Count, and VEGF on Metastasis in Patients with Nasopharyngeal Carcinoma
Authors: Xingming Ye , Lu Tianzhu , Bai Wendong , Jia Jing , Wang Lin , Zong Jingfeng , Chen Ying
Published: June 2020

Background Systemic inflammatory responses play important roles in tumor progression, including metastasis tendency. A high neutrophil-to-lymphocyte ratio (NLR) is associated with poor prognosis in nasopharyngeal carcinoma (NPC), but the underlying mechanisms are not clear. Vascular endothelial growth factor (VEGF) has been reported to be involved in the recruitment of pro-angiogenic neutrophils in tumor metastasis progress. Therefore, we focused on the correlations among NLR, neutrophil count, and VEGF during metastasis and explored the reasons for changes of NLR in advanced NPC.Methods Consecutive patients who had been investigated with magnetic resonance imaging and irradiated with intensity-modulated radiotherapy(IMRT) from November 2011 to December 2012 were studied retrospectively. Clinical parameters (NLR, neutrophil count) were measured and their association with NPC stage advancement and VEGF were assessed using the Kruskal–Wallis test. Survival curves were created using the Kaplan–Meier method and log-rank test.Results NLR was elevated in advanced N stage (P < 0.0001) and M stage disease (P = 0.0034), but not T stage disease (P = 0.7049). Changes to the NLR in advanced N stage and M stage disease were affected most strongly by neutrophil count (P = 0.0074 and P = 0.0064, respectively) and higher NLR levels were associated with higher neutrophil count (P < 0.0001). NLR > 2.26 and positive VEGF expression (+++) correlated significantly with distant metastasis-free survival (P = 0.0340 and P = 0.0023, respectively). Neutrophil counts correlated positively with VEGF expression (P = 0.0024) in NPC tissue.Conclusion Our results demonstrate a positive correlation between NLR, neutrophil count, and VEGF expression in NPC. Higher NLR and VEGF expression are associated with distant metastasis-free survival among patients with NPC, which implies that they set a basis of immune activation in advanced nasopharyngeal carcinoma.
FeS Encapsulated Chitosan Graft Polyacrylamide Nanocomposite for the Uptake of Model Anionic Eosin Y from Water: Isotherm, Kinetics and Equilibrium Studies.
Authors: Danu Bernice Y. , Agorku Eric S. , Ampong Francis K. , Awudza Johannes A.M. , Torve Vincent , Amponsah Caleb , Quaye Ruth N.M , Ama Onoyivwe M. , Osifo Peter O. , Ray Suprakas S.
Published: June 2020

A novel bio-nanocomposite, FeS encapsulated chitosan grafted polyacrylamide, was successfully synthesized using a grafting technique that employs microwave irradiation. Employing FTIR, SEM, XRD, TEM and SAED analysis, the synthesized nanocomposites were characterized. Thermodynamic and kinetic studies were accomplished using the batch mode via the eosin yellow adsorption from aqueous solution using the nanocomposite. The adsorption process was tailored to the pseudo-second-order kinetic model and the Freundlich isotherm model. The enthalpy change, ∆H° (-12.243 kJ/mol), was an exothermic process. The Gibbs energy, ∆G° (from -5.492 kJ/mol.K to -5.078 kJ/mol.K for temperatures from 300 K to 318 K respectively) values were indications of a thermodynamically feasible reaction process which was spontaneous within the temperature domain. The change in entropy, ∆S° (-0.023 kJ/mol), showed reduced randomness during the adsorption process. The mean free energy of adsorption was 0.408 kJ/mol, which was an indication of physisorption. These results show the possible use of the graft copolymer as an adsorbent in water treatment.
Evaluation of the Autof MS 1000 mass spectrometer for identification of clinical isolates
Authors: Ma Qiong , Zhang Qi , Yuan Youhua , Yan Wenjuan , Wan Shanmei , Xu Junhong , Zhang Jiangfeng , Wang Yuming , Li Yi
Published: June 2020

Background: To evaluate the accuracy and performance of Autof MS 1000 mass spectrometer in bacterial and yeasts identification., a total of 2342 isolates were routinely obtained from microbial cultures of clinical specimens (i.e., blood, cerebrospinal fluid, respiratory tract, Puncture fluid, wound, stool and urine) from January to December 2019 in Henan Provincial People’s Hospital. Then, the repetitive strains of the same patient were excluded. The two mass spectrometry methods by Autof MS 1000 and Bruker biotyper systems and the classical biochemical VITEK 2/API 20C AUX Systems testing were used for analysis. The strains with different results by the above three test methods were identified by 16S rDNA and other specific genes sequencing.Results: The accuracies of isolates identification at species level by Autof MS 1000 and Bruker biotyper systems were 98.9% and 98.5%, respectively. The genus level by Autof MS 1000 and Bruker biotyper systems were 99.7% and 99.4%, respectively. The Autof instrument was not significantly different from the Bruker instrument in identification accuracy at both the species and genus levels. The frequencies of unreliable identification were 1.1% (26/2342) for Autof ms1000 and 1.5% (34/2342) for Bruker biotyper, respectively. The results of in vitro experiments demonstrated that the coincidence rate of the Autof ms1000 mass spectrometers in the identification for five types of bacteria is over 93%, the identification error is less than 3%, and the no identification rate is 0. It was indicated Autof ms1000 identification was an acceptable method.Conclusions: Autof MS 1000 mass spectrometer can be utilized to identify clinical isolates. An upgrade database is recommended to correctly identify rare strains.