bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure based engineering for substrate specificity of pinoresinol-lariciresinol reductases
Authors: Xiao Ying , Shao Kai , Zhou Jingwen , Wang Lian , Wu Di , Chen Junfeng , Feng Jingxian , Qiu Shi , Zhang Lei , Zhang Peng , Chen Wansheng
Published: July 2020

Pinoresinol–lariciresinol reductases (PLR) are enzymes involved in the lignan biosynthesis after the initial dimerization of two monolignols, which represents the entry point for the synthesis of 8-8′ lignans and contributes greatly to their structural diversity. Of particular interest has been in determining how differing substrate specificities are achieved with these enzymes. Here, we present crystal structures of IiPLR1/AtPrR1/AtPrR2 in the apo, substrate-binding and product-binding forms. Each structure contains a head-to-tail homodimer, and the catalytic pocket comprises structural elements from both monomers. A loop β4 covers the top of the pocket, and residue 98 from the loop governs catalytic specificity. Structure-guided mutagenesis could switch the substrate specificity of IiPLR1 and AtPrR2, respectively. Our study provides new insight into the molecular mechanism underlying the substrate specificity of PLR/PrRs and suggests an efficient strategy for the large-scale commercial production of the pharmaceutically valuable compound lariciresinol.
Haemophilus Influenza Coinfection is Common in COVID-19 Patients
Authors: yan junping , Hu liangshan , Zou Seyin , liu guochen , cao donglin
Published: July 2020

Background: The combined infection rate and bacterial spectrum has not been reported in COVID-19 patients. Methods: Constant temperature amplification reaction and real-time fluorescence analysis was performed for common bacterial respiratory pathogens on sputum samples (spontaneous or induced) from a prospective cohort study of infections. Forty-nine suspected COVID-19 cases from Guangdong Second Provincial General Hospital were included in the study, 49.0% were male. Results: Probable bacterial infection was detected in 33 participants. Haemophilus influenzae was the most common bacterial pathogens detected. Conclusions: Multiple coinfections were commonly detected. Sputum multiplex PCR could become a useful diagnostic tool for bacterial respiratory infections in COVID-19 infected inpatients.
New concept on association of FGFR4 G388R, V10I polymorphisms and risk of cancer
Authors: Peng Tao , Zhang Ze , Sun Yang-Yang , Xu Kai , Wu Hao , Zhang Wei , Yuan Wei , Zuo Li , Zhang Lifeng , Mi Yuan-Yuan , Zhou Xiao-Li
Published: July 2020

Background: The correlation between G388R, V10I polymorphisms of fibroblast growth factor receptor (FGFR) 4 gene and risk of carcinoma has been investigated previously, but the results are contradictory.Methods: Odds ratios (ORs) with 95% confidence intervals (95% CIs), in silico tools and immunohistochemical staining (IHS) were adopted to assess the association. Results: Totally, 13,793 cancer patients and 16,179 controls were evaluated in the pooled analysis. When all the studies were summarized, we found that G388R polymorphism is associated with elevated susceptibility to cancer under homozygous comparison (OR = 1.21, 95%CI = 1.03 - 1.43, P = 0.020) and recessive genetic model (OR = 1.21, 95%CI = 1.04 - 1.41, P = 0.012). In stratification analysis by cancer type and ethnicity, similar findings were indicated in prostate cancer, breast cancer, and Asian descendants. Polyphen2 bioinformatics analysis showed that the G388R mutation is predicted to be possibly damaging to the protein function of FGFR4. IHS analysis indicated that the FGFR4 expression is increased in more advanced prostate cancer. Conclusion: FGFR4 G388R polymorphism may be associated with cancer risk, especially in prostate cancer, breast cancer, and Asian descendants. Up-regulation of FGFR4 may be related to a poor prognosis in prostate cancer.
The Role of Raw Material Prices in Renewable Energy Diffusion
Authors: Nabi Agha Amad , Magsi Muhammad Azhar , Ramakrishnan Suresh , Tunio Fayaz Hussain
Published: July 2020

The foremost need for countries especially Pakistan and other Asian countries is the hunt for renewable and alternative energy because the scarcity of energy is faced by many countries like Pakistan. There are a number of approaches seeking to demonstrate the diffusion of renewable energy technologies (RET). Learning and experience curves are the highest generally exercised instruments, followed by further economic, policy- and barrier-related analyses. The purpose of this study is to support research on the role of raw material prices specifically oil price and gas price on Renewable energy diffusion. Panel regression with fixed effects model is applied on data of 3 Asian countries namely Pakistan, India, and China for the period 1990 to 2012 gathered from World Bank and EIA (Energy Information Administration). The findings reveal that the model confirms an adequate fit and a very significant influence of oil prices on investments in renewable energy technology capacity whereas the insignificant influence of natural gas prices in a renewable energy technology capacity.
Changing Primary Energy Consumption Due to COVID-19: The Study 20 European Economies
Authors: Mirnezami Seyed Reza , Rajabi Sajad
Published: July 2020

With the outbreak of the coronavirus in countries around the world, governments have decided to impose restrictions and social distancing. Closures of businesses, and hence changes in supply and demand patterns during this period, have deepened concerns among policy makers. In this article, we investigate the change in primary energy consumption in the 20 European countries that have the highest GDP. To this end, 10 different shock scenarios and its limitations are considered. By implementing these shocks into input-output modelling, changes in primary energy consumption are calculated. The results show that according to the best scenario (rapid and complete economy restoration), Russia with 3.5% and Italy with 2.88% will have the largest decrease, and according to the worst case scenario (explosive exacerbation of disease and complete quarantine), Spain with 14% and Italy with 13% will have the largest reduction in energy consumption. In addition, considering the total changes in primary energy consumption of these 20 countries, according to the best scenario, it will decrease by 1.81% and according to the worst-case scenario, it will decrease by 10.46%. We discuss about possibilities that energy consumption permanently declines.
Exosomes from Gastric Cancer Suppressed Adipo-differentiation of Adipose Mesenchymal Stem Cells to Promote Cancer-associated Cachexia via miR-155/ C/EPBβ pathway
Authors: Liu Ying , Lin Dan , Wang Huiya , Zhang Haiyang , Deng Ting , Liu Rui , Ning Tao , Bai Ming , Ying Guoguang , Ba Yi
Published: July 2020

BACKGROUND: Cancer-associated cachexia (CAC) is defined as a multifactorial syndrome including depletion of adipose tissue and skeletal muscle. Adipose tissue wasting, as a key characteristic of CAC, occurs early and is related with poor survival. However, the influence of exosomes on adipo-differentiation in CAC remained be mysterious.METHODS: Oil-red staining, western blotting, and real-time polymerase chain reaction (RT-PCR) were used to investigate the adipo-differentiation capacity of A-MSCs from GC patients and healthy donors. Adipo-differentiation capacity of A-MSCs treated with exosomes from GES-1 or GC cell lines was also detected. To further explore the effects of exosomal miR-155 on adipo-differentiation in vitro, we carried out luciferase reporter assay. Finally, to evaluate the function of exosomal miR-155 in vivo, BALB/c mice were subcutaneously transplanted with SGC7901 cells transfected with lentivirus containing a miR-155 overexpressing (miR-155 OE) sequence or miR-155 shRNA (miR-155 KO) or control lentivirus(NC) to observe the change of adipo-differentiation of A-MSCs.RESULTS: We showed that miR-155 was high expressed in adipose mesenchymal stem cells (A-MSCs) isolated from GC patients, which exhibited significantly suppressed adipo-differentiation. Mechanistically, targeting C/EPBβ and suppressing C/EPBα and PPARγ by GC exosomal miR-155 was demonstrated to be involved in impairing the differentiation of A-MSCs into adipocytes. The expression of C/EPBβ C/EPBα and PPARγ were rescued through downregulating miR-155 in GC exosomes. Moreover, overexpression of miR-155 improved cancer cachexia in tumor-implanted mice, charactered by weight loss, tumor progression and low expression of C/EPBβ, C/EPBα, and PPARγ in A-MSCs as well as FABP4 in tumor-related adipose tissue. Decreasing level of miR-155 in implanted tumor blocked the anti-adipogenic effects of GC. CONCLUSION: GC exosomsal miR-155 suppressed adipo-differentiation of A-MSCs via targeting C/EPBβ of A-MSCs plays a crucial role in CAC.
Frequency of radial artery occlusion with transradial pneumatic compression band after cardiac catheterization
Authors: Hashmi Kashif Ali , Iqbal Zahid , Hashmi Atif Ali , Shoaib Maira , Irfan Muhammad , Khan Rabeet , Ali Nauman , Khan Amir , Edhi Muhammad M.
Published: July 2020

Objectives Radial artery occlusion is a silent complication of a transradial approach to cardiac catheterization that may complicate subsequent transradial procedures in patients undergoing cardiac catheterization. A transradial band reduces vascular complications and provides brisk, powerful and effective haemostasis. The purpose of this study was to assess the frequency of radial artery occlusion in 180 patients undergoing transradial coronary catheterization.Results The mean age of the study cohort was 54.19 ± 12.30 years. Radial artery occlusion was found in 14 (7.8%) patients. When stratifying by age group and sex, there was no significant difference in radial artery occlusion between age groups and sex. It was likewise found that comorbidities such as diabetes mellitus, hypertension and smoking, increased the risk of radial artery occlusion however this was observed to be significant only for diabetes mellitus. We therefore conclude that a transradial pneumatic pressure band is an extremely helpful and safe strategy to prevent radial artery occlusion.
Trilobatin Ameliorates Insulin Resistance through IRS-AKT-GLUT4 Signaling Pathway in C2C12 Myotubes and ob/ob Mice
Authors: Liu Min , Wang Lujing , Li Xigan , Wu Yucui , Yin Fei , Liu Jianhui
Published: July 2020

Background: Trilobatin, a natural compound, has been found to exhibit anti-diabetic properties in high-fat diet (HFD) and streptozotocin (STZ) induced type 2 diabetic mice. But up to now no research has been reported on the effect of trilobatin on insulin resistance in peripheral tissues. Herein, we determined the effects of trilobatin on insulin resistance in palmitate-treated C2C12 myotubes and ob/ob mice.Methods: 8-10 weeks of male ob/ob mice and same background C57BL/6 mice were used to evaluate the role of trilobatin on insulin resistance; Protein expression and phosphorylation were measured by western blot; Glucose uptake was determined a fluorescent test.Results: treatment with trilobatin prevented palmitate-induced insulin resistance by enhancing glucose uptake and the phosphorylation of IRS1 and AKT, recovered the translocation of GLUT4 from cytoplasm to membrane, but preincubation with LY294002, an inhibitor of PI3K, blocked the effects of trilobatin on glucose uptake and the distribution of GLUT4 in C2C12 myotubes. Furthermore, administration with trilobatin for 4 weeks significantly improved insulin resistance by decreasing fasting blood glucose and insulin in serum, enhancing the phosphorylation of IRS1 and AKT, and recovering the expression and translocation of GLUT4 in ob/ob mice.Conclusions: IRS-AKT-GLUT4 signaling pathway might be involved in trilobatin ameliorating insulin resistance in skeletal muscle of obese animal models.
Whole metagenomic sequencing reveals different compositions of pathogenic bacteria in patients with appendicitis:Bacterial culture is not suitable as the only therapeutic guidance
Authors: Yuan Jie , Qiu Enming , Han Shuai , Li Zhou
Published: July 2020

Background

Appendicitis is the result of a combination of factors, including bacterial infection, anatomy, blood supply, and intestinal contents. Previous diagnosis and treatment guidelines have suggested that bacteria are associated with the severity of appendicitis, and the use of postoperative antibiotics should be guided according to the results of intraoperative sample culture. However, this approach has many limitations. Therefore, in the present study, the relationship between pathogenic bacteria and appendicitis was assessed.
Result

We conducted a nonconsecutive case series analysis from January to July 2017. Nineteen patients were divided into two groups according to their intraoperative gross pathology and postoperative histological and bacterial culture results. During appendectomy, the diseased appendices were collected, and whole metagenomic sequencing was performed to identify the pathogenic bacteria in the specimens. We identified 361 species in the appendix samples. Six species in the appendix samples had relative abundances > 5%. No significant differences were observed in the bacterial composition of the three assayed groups. In particular, according to the grouping of culture results, the sequencing analysis results were completely different from those of the culture-based method.
Conclusion

Bacterial culture results are not suitable for exclusively guiding the use of antimicrobial agents after appendicitis. Next-generation sequencing has numerous advantages, such as in precisely characterizing the profiles of microbiota and their antibiotic resistance in appendicitis patients. Based on the above results, we propose that a combination of bacterial culture and next-generation sequencing should be used to improve the efficacy of guiding antibiotic therapy.
Phylogenetic characterization and evolution of the VP4 gene of P[9] rotaviruses
Authors: Ahmed Sharnali , Yahiro Takaaki , Emran Nor Amalina , Amit Lia Natasha , Iha Hidekatsu , Ahmed Kamruddin
Published: July 2020

Objectives: Rotavirus is one of the major causes of gastroenteritis in children under 5 years of age and is responsible for over 200,000 deaths annually. Rotavirus can evolve by reassortment, in which gene segments are exchanged between strains of different origins. Rotavirus strains with the P[9] genotype is an example of reassortment, in which the P[9] genotype is from feline species. A number of outbreaks by P[9] strains have been documented in several countries. However, details regarding the epidemiological relationships between the strains remains largly unknown. Therefore, in the present study, genetic characterization and evolutionary analyses were perforemd to gain insight into P[9] strains circulating in different parts of the world. Results: The P[9] strains could be divided into five lineages, and that the common ancestor of currently circulating P[9] strains is around 168 years old. In each lineage, the strains were not only from different countries, but also from different continents. These findings suggest that none of the lineages has a specific region of distribution, and although humans have had interactions with cats for thousands of years, the ancestor of the current P[9] strain is relatively recent.
Development and validation of an electronic frailty index using routine electronic health records: an observational study of 49,226 elderly inpatients from a general hospital in China
Authors: Liang Yao-Dan , Xie Yi-Bo , Du Ming-Hui , Shi Jing , Wang Hua , Yang Jie-Fu
Published: July 2020

Background Frailty assessment based on routine electronic health records (EHR) may be a good alternative to time-consuming frailty scales. This study mainly aimed to develop and validate an electronic frailty index (eFI) using routine EHR for elderly inpatients and analyse the correlations between frailty and hospitalized events and costs.Methods Based on the cumulative deficit model, we created an eFI from routine EHR. In a prospective cohort, we validated the effectiveness of the eFI by consistency with the comprehensive geriatric assessment-frailty index (CGA-FI). Then, we analysed the correlations between frailty and hospitalized events by logistic regression and costs by generalized linear regression models.Results During the study period, 49,226 elderly inpatients from the EHR were included in the analysis. There were 42,821 (87.0%) patients with sufficient data to calculate an eFI. The cut-off value for the upper tertile of the eFI for these patients was 0.15. A strong correlation between the CGA-FI and eFI was shown in the validation cohort of 685 subjects (Pearson’s r = 0.716, P < 0.001). The sensitivity and specificity for an eFI ≥ 0.15 to identify frailty defined as a CGA-FI ≥ 0.25 were 64.8% and 88.7%, respectively. After adjusting for age, gender, and operation, an eFI ≥ 0.15 showed an independent association with long hospital stay (odds ratio [OR] = 2.889, P < 0.001) and death in hospital (OR = 19.97, P < 0.001) for elderly inpatients from all departments. Moreover, after adjusting for age, gender, and operation, eFI values (per 0.1) were positively associated with total costs (β = 0.453, P < 0.001), examination costs (β = 0.269, P < 0.001), treatment costs (β = 0.414, P < 0.001), nursing costs (β = 0.381, P < 0.001), pharmacy costs (β = 0.524, P < 0.001), and material costs (β = 0.578, P < 0.001) for elderly inpatients from all departments.Conclusions It is feasible to develop an effective eFI from routine EHR for elderly inpatients from a general hospital in China. Frailty is an independent risk factor for long hospital stay and death in hospital. As the degree of frailty increases, the hospitalized costs for elderly inpatients increase accordingly.
Conditional disruption of AMP kinase in dopaminergic neurons promotes Parkinson’s disease-associated phenotypes in mice
Authors: Hang Liting , Goh Geraldine W.Y. , Wang Ziyin , Choong Huey Ching , Thundyil John , Xu Shengli , Lam Kong Peng , Lim Kah-Leong
Published: July 2020

Emerging studies implicate energy dysregulation as an underlying trigger for Parkinson’s disease (PD), suggesting that a better understanding of the molecular pathways governing energy homeostasis could help elucidate therapeutic targets for the disease. A critical cellular energy regulator is AMP kinase (AMPK), which we have previously shown to be protective in PD. However, precisely how AMPK function impacts on dopaminergic neuronal survival and disease pathogenesis remains elusive. Here, we created a tissue-specific AMPK-knockout mouse model where the catalytic subunits of AMPK are ablated in nigral dopaminergic neurons. Using this model, we demonstrated that loss of AMPK function promotes dopaminergic neurodegeneration and associated locomotor aberrations. Accompanying this is a substantial reduction in the number of mitochondria in the surviving AMPK-deficient nigral dopaminergic neurons, suggesting that an impairment in mitochondrial biogenesis may underlie the observed PD-associated phenotypes. Importantly, the loss of AMPK function enhances the susceptibility of nigral dopaminergic neurons in these mice to 6-hydroxydopamine-induced toxicity. Taken together, these findings highlight the importance of neuronal energy homeostasis by AMPK in PD and position AMPK pathway as an attractive target for future therapeutic exploitation.
Can indices of myocardial damage predict carbon monoxide poisoning outcomes?
Authors: Koga Hitoshi , Tashiro Hideki , Mukasa Kouta , Inoue Tomohiro , Okamoto Aya , Urabe Shougo , Sagara Shuuichirou , Yano Kazumi , Onitsuka Kouhei , Yamashita Hisashi
Published: July 2020

Background

Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is not clear, however, whether the indices of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relation between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning.
Results

Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated. The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were hyperbaric oxygen therapy (P = 0.0182), corrected QT dispersion (P = 0.0062), and troponin I level (P = 0.0002).
Conclusions

Patients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.
PTK7-Targeting CAR T-cells for the Treatment of Lung Cancer and other Malignancies
Authors: Jie Yamin , Liu Guijun , Feng Lina , Li Ying , E Mingyan , Wu Liangliang , Rong Guanghua , Li Yongwu , Wei Huafeng , Gu Anxin
Published: July 2020

Background: In spite of impressive success in treating hematologic malignancies, adoptive therapy with chimeric antigen receptor modified T cells (CAR T) has not yet been effective in solid tumors, where identification of suitable tumor-specific antigens remains a major obstacle for CAR T-cell therapy due to the “on target off tumor” toxicity. Protein tyrosine kinase 7 (PTK7) is a member of the Wnt-related pseudokinases and identified as a highly expressed antigen enriched in cancer stem cells (CSCs) from multiple solid tumors, including but not limited to triple-negative breast cancer, non-small cell lung cancer, and ovarian cancer, suggesting it may serve as a promising tumor-specific target for CAR T-cell therapy. Methods: In this study, we constructed 3 different PTK7-specific CAR (PTK7-CAR1/2/3) each comprising a humanized PTK7-specific single chain variable fragment (scFv), hinge and transmembrane (TM) regions of the human CD8α molecule, 4-1BB intracellular co-stimulatory domain (BB-ICD), and CD3ζ intracellular domain (CD3ζ-ICD) sequence, and then prepared the CAR T cells by lentivirus mediated transduction of human activated T cells accordingly, and sequentially evaluated their antigen-specific recognition and killing activity in vitro and in vivo.Results: T cells transduced with all 3 PTK7-CAR candidates exhibited antigen-specific cytokine production and potent cytotoxicity against naturally expressing PTK7-positive tumor cells of multiple cancer types without mediating cytotoxicity of a panel of normal primary human cells; meanwhile, in vitro recursive cytotoxicity assays demonstrated that only PTK7-CAR2 modified T cells retained effective through multiple rounds of tumor challenge. Using in vivo xenograft models of lung cancers with different expression level of PTK7, systemic delivery of PTK7-CAR2 modified T cells significantly prevented tumor growth and prolonged overall survival of mice. Conclusion: Altogether, our results support PTK7 as a therapeutic target suitable for CAR T-cell therapy that could be applied for lung cancers and many other solid cancers with PTK7 overexpression.
The molecular basis of socially-mediated phenotypic plasticity in a eusocial paper wasp
Authors: Taylor Benjamin , Cini Alessandro , Wyatt Christopher , Reuter Max , Sumner Seirian
Published: July 2020

Phenotypic plasticity, the ability to produce multiple phenotypes from a single genotype, represents an excellent model with which to examine the relationship between gene expression and phenotypes. Despite this, analyses of the molecular bases of plasticity have been limited by the challenges of linking individual phenotypes with individual-level gene expression profiles, especially in the case of complex social phenotypes. Here, we tackle this challenge by analysing the individual-level gene expression profiles of Polistes dominula paper wasps following the loss of a queen, a perturbation that induces some individuals to undergo a significant phenotypic shift and become replacement reproductives. Using a machine learning approach, we find a strong response of caste-associated gene expression to queen loss, wherein individuals’ expression profiles become intermediate between queen and worker states. Importantly, this change occurs even in individuals that appear phenotypically unaffected. Part of this response is explained by individual attributes, most prominently age. These results demonstrate that large changes in gene expression may occur in the absence of detectable phenotypic changes, resulting here in a socially mediated de-differentiation of individuals at the transcriptomic but not the phenotypic level. Our findings also highlight the complexity of the relationship between gene expression and phenotype, where transcriptomes are neither a direct reflection of the genotype nor a proxy for the molecular underpinnings of the external phenotype.
Hybrid memristor-CMOS neurons for in situ learning in fully hardware memristive spiking neural networks
Authors: Zhang Xumeng , Lu Jian , Wang Rui , Wei Jinsong , Shi Tuo , Dou Chunmeng , Wu zuheng , Shang Dashan , Xing Guozhong , Liu Qi , Liu Ming
Published: July 2020

Spiking neural network, consisting of spiking neurons and plastic synapses, is a promising but relatively underdeveloped neural network for neuromorphic computing. Inspired by the human brain, it provides a unique solution for highly efficient data processing. Recently, memristor-based neurons and synapses are becoming intriguing candidates to build spiking neural networks in hardware, owing to the close resemblance between their device dynamics and the biological counterparts. However, the functionalities of memristor-based neurons are currently very limited, and a hardware demonstration of fully memristor-based spiking neural networks supporting in situ learning is very challenging. Here, a hybrid spiking neuron by combining the memristor with simple digital circuits is designed and implemented in hardware to enhance the neuron functions. The hybrid neuron with memristive dynamics not only realizes the basic leaky integrate-and-fire neuron function but also enables the in situ tuning of the connected synaptic weights. Finally, a fully hardware spiking neural network with the hybrid neurons and memristive synapses is experimentally demonstrated for the first time, with which in situ Hebbian learning is achieved. This work opens up a way towards the implementation of spiking neurons, supporting in situ learning for future neuromorphic computing systems.
Evaluation of the effects of an interdisciplinary lifestyle and health program for adolescents and its benefits for maintaining health.
Authors: Schuster Anja , Schwenoha Karin , Oberkofler Edith , Lirk Gerald , Ardelt-Gattinger Elisabeth , Weghuber Daniel , Ring-Dimitriou Susanne , Freudenthaler Thomas , Oostingh Gertie J. , Bogner Barbara
Published: July 2020

Background

Obesity numbers have doubled worldwide since 1980, leading to individual life-quality threatening issues and a socioeconomic challenge. A number of school programs have been initiated to prevent the epidemic-like spreading of obesity.
Methods

109 adolescents (42 females and 67 males aged 15.0 ± 0.7 years) were included into this six-month interdisciplinary school-based study. The aim was to assess various implementation outcomes based on the effect of health education, including the promotion of healthy eating patterns and a limitation of sugar-containing beverage consumption via the feedback of analysed anthropometric data, biomedical parameters, physical fitness tests and an eating and physical activity behaviour questionnaire.
Results

Overall, the results demonstrated a positive effect on body fat content and physical activity. In addition, a trend towards a benefit on parameters of muscle and fat metabolism was detected.
Conclusions

An interdisciplinary life-style program integrated into the school curriculum is suited to have a positive impact on health outcomes. By enhancing the awareness for healthy nutrition and the importance of physical activity, self-empowerment was increased, resulting in an improvement of health-associated parameters.
Evolutionary and genomic analysis of four SARS-CoV-2 isolates circulating in March 2020 in Sri Lanka; Additional evidence on multiple introduction and further transmission
Authors: Satharasinghe Dilan Amila , Parakatawella Parakatawella Mudiyanselage Shalini Daupadi Kumari , Premarathne Jayasekara Mudiyanselage Krishanthi Jayarukshi Kumari , Jayasooriya L. J.P. Anura P. , Prathapasinghe Gamika A. , Yeap Swee Keong
Published: July 2020

The molecular epidemiology of the virus, and mapping help to understand the evolution of the epidemics and apply quick control measures. The study genomic evidence of multiple SARS-CoV-2 introductions into Sri Lanka and virus evolution during circulation. Whole-genome sequences of four SARS-CoV-2 strains obtained from COVID-19 positive patients reported in Sri Lanka during March 2020 were compared with sequences from Europe and elsewhere. The phylogenetic analysis revealed that the sequence of the sample of first local patient collected on 10th March, who contacted tourists from Italy, was clustered with SARS-CoV-2 strains collected from Italy, Germany, France and Mexico. Subsequently, the sequence of the isolate obtained on 19th March also clustered in the same group with the samples collected in March and April from Belgium, France, India, and South Africa. The other two strains of SARS-CoV-2 were segregated from the main cluster, and the sample collected from 16th March clustered with England and the sample collected on 30th March showed the highest genetic divergent to the isolate of Wuhan, China. Here we report the first molecular epidemiological study conducted on circulating SARS-CoV-2 in Sri Lanka. The finding provides the robustness of molecular epidemiological tools and its application in tracing possible exposure in disease transmission during the pandemic.
The effect and mechanism of Dufulin in controlling tomato yellow leaf curl virus on tomato plants
Authors: Huang Liping , Wang Shuaixin , Zhang Zhuo , Zhou Xuguo , Zhang Zhanhong , Zheng Limin , Gao Yang , Hu Fang , Zhang Deyong , Tan Xinqiu , Shi Xiaobin , Liu Yong
Published: July 2020

Background: Tomato yellow leaf curl virus (TYLCV) causes critical production loss in tomato cultivation. The control of TYLCV in tomato is done mainly by using pesticide which is difficult and expensive, making it essential to find an environmentally friendly chemical agent to control TYLCV. Dufulin has been widely used to prevent and control viral diseases in tobacco and rice in recent years. In this study, we investigated the effect and mechanism of Dufulin on TYLCV on tomato plants.Methods: The control effect of Dufulin on TYLCV was evaluated by field experiments. The expression level of PI II and NPR1 in healthy and TYLCV-infected tomato after treatments were determined by Real-time fluorescent quantitative PCR (qRT-PCR). Handheld chlorophyll meter was applied to compare the content of chlorophyll and nitrogen in healthy and TYLCV-infected tomato after treatments.Results: It showed that the relative control effect of 20% Dufulin on TYLCV reached above 68% in 2018 to 2020. Jasmonic acid (JA) level was higher on healthy tomato, but lower on TYLCV-infected tomato plants treated with Dufulin compared to control. Salicylic acid (SA) level was higher on healthy and TYLCV-infected tomato plants treated with Dufulin compared to control. Chlorophyll content on healthy and TYLCV-infected tomato plants was higher after treatment with Dufulin compared to control. Nitrogen content on tomato plants showed no significant difference after spraying Dufulin compared to control.Conclusions: We found the first evidence of control effects TYLCV using Dufulin. It induced plant defense and increased plant chlorophyll content to help plants resist infection which is helpful for future control of TYLCV in tomato.
Establishment of a clinical nomogram model to predict the progression of COVID-19 to severe disease
Authors: tu changli , Wang Guojie , Tan Cuiyan , Chen Meizhu , Xiang Zijun , Peng Hu , Wang Ying , Liang Yingjian , Huang Yiying , Wang Zhenguo , Wu Jian , Cao Qizhen , Han Qiang , Xu Lin , Huang Jin , Zheng Xiaobin , Chen Qiuyue , Geng Yayuan , Guo Na , Zhou Xiaorong , Liu Xinran , Cui Ning , Liu Jing , Shan Hong
Published: July 2020

Background

Coronavirus disease 2019 (COVID-19) is a worldwide public health pandemic with a high mortality rate, among severe cases. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. It is important to ensure early detection of the virus to curb disease progression to severe COVID-19. This study aimed to establish a clinical-nomogram model to predict the progression to severe COVID-19 in a timely, efficient manner.
Methods

This retrospective study included 202 patients with COVID-19 who were admitted to the Fifth Affiliated Hospital of Sun Yat-sen University and Shiyan Taihe Hospital from January 17 to April 30, 2020. The patients were randomly assigned to the training dataset (n = 163, with 43 progressing to severe COVID-19) or the validation dataset (n = 39, with 10 progressing to severe COVID-19) at a ratio of 8:2. The optimal subset algorithm was applied to filter for the clinical factors most relevant to the disease progression. Based on these factors, the logistic regression model was fit to distinguish severe (including severe and critical cases) from non-severe (including mild and moderate cases) COVID-19. Sensitivity, specificity, and area under the curve (AUC) were calculated using the R software package to evaluate prediction performance. A clinical nomogram was established and performance assessed with the discrimination curve.
Results

Risk factors, including demographics data, symptoms, laboratory and image findings were recorded for the 202 patients. Eight of the 52 variables that were entered into the selection process were selected via the best subset algorithm to establish the predictive model; they included gender, age, BMI, CRP, D-dimer, TP, ALB, and involved-lobe. Sensitivity, specificity and AUC were 0.91, 0.84 and 0.86 for the training dataset, and 0.87, 0.66, and 0.80 for the validation dataset.
Conclusions

We established an efficient and reliable clinical nomogram model which showed that gender, age, and initial indexes including BMI, CRP, D-dimer, involved-lobe, TP, and ALB could predict the risk of progression to severe COVID-19.
Informing the real-world implementation of a home-based physical activity program for mothers at risk of postnatal depression: Perspectives from key stakeholders.
Authors: Teychenne Megan , Apostolopoulos Maria , Ball Kylie , Olander Ellinor K , Opie Rachelle S , Rosenbaum Simon , Laws Rachel
Published: July 2020

Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform development and implementation of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up.Methods In September to November 2019, representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11) participated in semi-structured interviews exploring their perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Thematic analyses were used for qualitative data.Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services.Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.
The prevalence of low health literacy and its socio-demographic risk factors in Hebei: a provincially cross-sectional survey
Authors: Yang Qiuxia , Yu Shuli , Wang Changhong , Gu Guoxiao , Yang Ziwen , Liu Huihui , Lin Linghui , Qiao Yu , Yu Lijing , Feng Qiang , Niu Guangxu
Published: July 2020

Background: This study aimed to evaluate the prevalence of low health literacy in Hebei Province of China, and to investigate its socio-demographic risk factors.Methods: This study was a community-based, cross-sectional questionnaire survey with a multiple-stage randomization design and a sample size of 10560. Participants’ health literacy status was evaluated by a questionnaire based on the 2012 Chinese Resident Health Literacy Scale. Meanwhile, participants’ socio-demographic characteristics were also collected by the questionnaire.Results: A total of 9952 participants provided valid questionnaires and were included in the final analyses. The mean health literacy score was 63.1±17.1 points; for its subscales, the mean basic knowledge and concepts score, lifestyle score, health-related skills score were 31.7±9.0, 17.2±4.8, 14.3±4.1, respectively. Meanwhile, low health literacy prevalence was 81.0%; for its subscales, low basic knowledge and concepts prevalence (70.6%) was numerically reduced compared to low lifestyle prevalence (87.4%) and low health-related skills prevalence (86.1%). Further analyses showed that age, male and rural area were positively associated, but education level and annual household income were negatively associated with low health literacy prevalence. Further multivariate logistic regression analyses showed that higher age, male, lower education level, lower annual household income and rural area were closely correlated with the risks of low total health literacy or low health literacy in subscales in Hebei Province.Conclusion: The prevalence of low health literacy is 81.0% in Hebei Province. Meanwhile, higher age, male, lower education level, lower annual household income and rural area closely associate with low health literacy risk.
N2-3 Stage Nasopharyngeal Carcinoma Patients With Cervical Node Necrosis And Extracapsular Spread Benefit From Capecitabine Maintenance Chemotherapy
Authors: Liu Ting , Liu Siwen , Gu Yuting , Wen Xuehua
Published: July 2020

Purpose: The purpose of this study was to analyze the efficacy and toxicities of concurrent chemoradiotherapy plus capecitabine maintenance chemotherapy for N2-3 stage nasopharyngeal carcinoma (NPC) with cervical node necrosis (CNN) and extracapsular spread(ECS).Patients and methods: This study included 283 N2-3 stage NPC patients with CNN and extracapsular spread who were treated with concurrent chemoradiotherapy. The prescribed doses delivered to the planning target volumes (PTVs), PTVnx, PTVnd, PTV1, and PTV2, were 68–72, 66–70, 60–64, and 52–56 Gy, respectively, in 30–32 fractions. All patients received induction chemotherapy followed by concurrent chemoradiotherapy with cisplatin alone (80–100 mg/m2, day 1, every 21 days is a cycle).Two weeks after completion of concurrent chemoradiotherapy, oral capecitabine (twice daily after meals for 14 consecutive days every 3 weeks) was administered to maintenance chemotherapy patients. Maintenance chemotherapy was administered for 6 months.Results: The 5-year overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 84.8%, 95.4%, and 86.6%, respectively, for all patients. The 5-year OS rates for patients who accepted capecitabine maintenance chemotherapy (group 1) and patients without maintenance chemotherapy (group 2) were 93.8% and 82.1% (P=0.021), respectively. The 5-year LRFS rates for groups 1 and 2 were 96.9% and 95.0% (P=0.467), respectively. The 5-year DMFS rates for groups 1 and 2 were 93.8% and 84.4% (P=0.044), respectively. Hand-Foot syndrome, myelotoxic effects, fatigue, and gastrointestinal symptoms were the common but not severe (grades 1–2) toxicities of the capecitabine maintenance chemotherapy.Conclusion: Capecitabine maintenance chemotherapy improves the outcome and reduces the occurrence of distant failure in N2-3 stage NPC patients with CNN and extracapsular spread. The side effects of treatment were generally tolerated. More clinical trials are required to evaluate the efficacy and toxicity of it.
Unimproved water sources in Ethiopia: Spatial variation and household point-of-use treatment practice based on 2016 Demographic and Health Survey
Authors: Tefera Yohannes , Geremew Abraham
Published: July 2020

Background

Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyse the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment practices using nationally representative data.
Method:

The data of 2016 Ethiopian Demographic and health survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on DHS cluster identification code. Global spatial autocorrelation was performed to analyse whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The point-of-use water treatment is analysed based on reported use of either boiling, bleach, filtration or SODIS.
Result

There were 5005 households using unimproved water sources for drinking purpose. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practices among these households is only 6.24%. The odds of point-of-use water treatment among household heads with higher education status is 2.5 times high (95%CI = 1.43–4.36) compared to those who did not attend education.
Conclusion

An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.
Health care seeking behavior for common childhood morbidities in Ethiopia: The effects of maternal behavior and access to key health services
Authors: Geda Nigatu R , Feng Cindy Xin , Whiting Susan J , Lepnurm Rein , Henry Carol J , Janzen Bonnie
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
Management of unexplained: poly-consultation and hyperfrequency on Primary Health Chilean Attention. A qualitative and exploratory study
Authors: Sánchez Nicolás Fuster , López Diego Rivera , Retamales Hugo Sir , Pérez Constanza Gómez , Torres Magdalena Delgado
Published: July 2020

Background: In Europe, Latin-America, and Asia, poly-consultation has become a complex problem for the management of different healthcare systems. However, in the current literature, little attention has been paid to exploring perspectives of territorial and critical analysis to manage unexplained symptoms.The purpose of this study is to analyze the socio-structural elements that underlie the users’ phenomenon of poly-consultation or hyperfrequency in the Chilean primary healthcare system (PHCS). Methods: This paper represents qualitative data collected as part of an exploratory study that used mixed methods across three metropolitan areas of Santiago, Valparaíso, and Concepción, Chile. The study involved a sample of 24 subjects from administrative and management positions in PHC who were recruited from Family Health Care Centers, considering urban municipalities from the low, medium, and high stratum.The study collected data using one set of semi-standardized interviews during a year. Data analysis used an qualitative content analysis.Results: This article shows that poly-consultant patients provide a critical clinic category to management and mental health model (foreshadowing a social topology base that promotes a determinate unspecific and diffuse experience on users) that cannot be cover by current biomedical models. Data showed the strain of a somatoform clinic category, especially in the clinic and epistemological exercise, and, also, the relevance of particularities of Chile, a country with a mixed health system characteristics and their effects: the naturalization of collective problems managed as individual problems. Conclusions: Results from the study have the potential to inform healthcare professionals and managers of strategies for developing effective and territorially based. We conclude that hyperfrequency and poly-consultation in Chile reveal relevant stratification in the territory who has particularities than could be studied from a quantitative perspective.