bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in survival among elders with disabilities: possible implications for long-term care insurance
Authors: Chen Cynthia , Lim Jue Tao , Chia Ngee Choon , Wang Lijia , Chong Ming Zhe , Cheong Angela , Fong Ngan Phoon , Tan Boon Yeow , Menon Edward , Ee Chye Hua , Lee Kok Keng , Chan Kin Ming , Ma Stefan , Tan Kelvin Bryan , Koh Gerald CH
Published: October 2020

Background Singapore is ageing rapidly and has one of the longest life expectancies in the world. Long-term care also represents one of the largest financial risks of the elderly, as the risk of disability increases with age. ElderShield, a long-term care insurance scheme provides payouts up to six years for elders with severe disability - having three or more ADL disabilities. The six years of coverage might be insufficient due to increases in the duration of the disability.Methods In this paper, we studied all elders admitted to community hospitals in Singapore from 1996 to 2005, linked with national death records until December 2011. We modelled their survival risk after discharge from community hospitals using Cox proportional hazards regression, taking into account ADL disability, health status and other sociodemographic covariates. Results Individuals with higher ADL disability counts have a higher hazard ratio (HR: 1.28,1.76,2.09 for mild, moderate and severe disability respectively compared to those with no disability), being in a higher subsidy ward class (HR: 1.13 and 1.41 for moderate and high subsidy respectively compared to no/low subsidy) and had greater comorbidity burden (HR: 1.33, 1.74, 2.74 for mild, moderate and severe comorbidity burden respectively compared to those with no comorbidity burden). We also found that survival probabilities for individuals with two disabilities were not statistically different from those with 3+ ADL disabilities. In addition, more elders with severe disability were living for longer than six years.Conclusions Our results indicated that individuals with ADL disability might be living longer. This has possible implications on long-term care policies in the context of ElderShield insurance as it uses severe ADL disabilities as the criteria for payout, capped at six years. In 2020, Singapore expanded to CareShield Life with lifetime cash payout if severely disabled. Ensuring fiscal sustainability and affordable premium is challenging for any government, especially with Singapore's rapidly ageing demography. We conclude that the expansion of coverage from six years to lifetime coverage is timely as Singaporeans are living longer and disability risk increases with age. These payouts will be helpful for the disabled elders and their family, protecting them against some financial risk.
From Fringe to Centre-Stage: experiences of mainstreaming health equity in a health research collaboration
Authors: Porroche-Escudero Ana , Popay Jennie , Ward Fiona , Ahmed Saiqa , Akeju Dorkas , Cloke Jane , Gabbay Mark , Hassan Shaima , Khan Koser , Kkhedmati-Morasae Esmaeil
Published: October 2020

Background: Action to address the structural determinants of health inequalities is prioritised in high level initiatives such as the UN Sustainable Development Goals and many national health strategies. Yet, the focus of much local policy and practice is on behaviour change. Research shows that whilst lifestyle approaches can improve population health, at best they fail to reduce health inequalities because they fail to address upstream structural determinants of behaviour and health outcomes. In health research most efforts have been directed at three streams of work: understanding causal pathways; evaluating the equity impact of national policy; and developing and evaluating lifestyle/behavioural approaches to health improvement. As a result, there is a dearth of research on effective interventions to reduce health inequalities that can be developed and implemented at a local level. Objective: To describe an initiative that aimed to mainstream a focus on health equity in a large scale research collaboration in the UK and to assess the impact on organisational culture, research processes and individual research practice. Methods: The study used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n=131 respondents including Public Advisers, university, NHS and local and document review.. Results: Utilising Extended Normalisation Process Theory (ENPT) and Gender Mainstreaming theory the evaluation illuminated: (i) the processes developed by CLAHRC NWC to integrate ways of thinking and acting to tackle the upstream social determinants of health inequities (i.e. to mainstream a health equity focus) and, (ii) the factors that promoted or frustrated these efforts. Conclusions: Findings highlight the role of contextual factors and processes aimed at developing and implementing a robust strategy for mainstreaming health equity as building blocks for transformative change in applied health research.
Transcriptome Analysis Reveals the Long Intergenic Noncoding RNAs Contributed to Skeletal Muscle Differences between Yorkshire and Tibetan Pig
Authors: Huang Ziying , Li Qianqian , Li Mengxun , Li Changchun
Published: October 2020

Background: The difference between the skeletal muscle growth rates of Western and domestic breeds is remarkable, but the potential regulatory mechanism involved is still unclear. Numerous studies have pointed out that long intergenic noncoding RNA (lincRNA) plays a key role in skeletal muscle development. This study used published Yorkshire (LW) and Tibetan pig (TP) transcriptome data to explore the possible role of lincRNA in the difference in skeletal muscle development between the two breeds. Results: Through differential expression analysis, 138 differentially expressed lincRNAs (DELs) were obtained between the two breeds, and their potential target genes (PTGs) were predicted. The results of Gene Ontology and pathway analysis revealed that PTGs are involved in multiple biological processes and pathways related to muscle development. The quantitative trait loci (QTLs) of DELs were predicted, and the results showed that most QTLs are related to muscle development. Finally, we constructed a co-expression network between muscle development related PTGs (MDRPTGs) and their corresponding DELs on the basis of their expression levels. The expression of DELs was significantly correlated with the corresponding MDRPTGs. Also, multiple MDRPTGs are involved in the key regulatory pathway of muscle fiber hypertrophy, which is the IGF-1-AKT-mTOR pathway. Conclusions: In summary, multiple lincRNAs that may cause differences in skeletal muscle development between the two breeds were identified, and their possible regulatory roles were explored. The findings of this study may provide a valuable reference for further research on the role of lincRNA in skeletal muscle development.
Estimated costs for the delivery of safer conception strategies for HIV-discordant couples in Zimbabwe: A cost analysis
Authors: Hughes Carolyn Smith , Brown Joelle , Murombedzi Caroline , Chirenda Thandiwe , Chareka Gift , Mhlanga Felix , Mateveke Bismark , Gitome Serah , Makurumure Tinei , Matubu Allen , Mgodi Nyaradzo , Chirenje Zvavahera , Kahn James G
Published: October 2020

Background: In recent years, safer conception strategies have been developed to help HIV-serodiscordant couples conceive a child without transmitting HIV to the seronegative partner. The SAFER clinical trial assessed implementation of these strategies in Zimbabwe. Methods: As a part of the SAFER study, we estimated the costs (in 2017 $US) associated with individual and combination strategies, in the trial setting and real-world practice, from a healthcare system perspective. Safer conception strategies included: 1) ART with frequent viral load testing until achieving undetectable viral load (ART-VL); 2) daily oral pre-exposure prophylaxis (PrEP); 3) semen-washing with intrauterine insemination; and 4) manual self-insemination at home. For costs in the trial, we used a micro-costing approach, including a time and motion study to quantify personnel effort, and estimated the cost per couple for individual and combination strategies for a mean of 6 months of safer services. For real-world practice, we modeled costs for three implementation scenarios, representing differences from the trial in input prices (paid by the Ministry of Health and Child Care [MOHCC]), intervention intensity, and increments to current HIV prevention and treatment practices and guidelines. We used one-way sensitivity analyses to assess the impact of uncertainty in input variables.Results: Individual strategy costs were $769-$1,615 per couple in the trial; $185-$563 if using MOHCC prices. Under the target intervention intensity and using MOHCC prices, individual strategy costs were $73-$360 per couple over and above the cost of current HIV clinical practices. The cost of delivering the most commonly selected combination, ART-VL plus PrEP, ranged from $166-$517 per couple under the three real-world scenarios. Highest costs were for personnel, lab tests, and strategy-specific consumables, in variable proportions by clinical strategy and analysis scenario. Total costs were most affected by uncertainty in the price of PrEP, number of semen-washing attempts, and scale-up of semen-washing capacity.Conclusions: Safer conception methods have costs that may be affordable in many low-resource settings. These cost data will help implementers and policymakers add safer conception services. Cost-effectiveness analysis is needed to assess value for money for safer conception services overall and for safer strategy combinations.Trial Registration:· Registry Name: Clinicaltrials.gov· Trial registration number: NCT03049176· Registration date: February 9, 2017· https://clinicaltrials.gov/ct2/show/NCT03049176
Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach
Authors: Ortiz-Prado Esteban , Simbana-Rivera Katherine , Gomez-Barreno Lenin , Tamariz Leonardo , Lister Alex , Baca Juan Carlos , Norris Alegria , Adana-Diaz Lila
Published: October 2020

Background: Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior health research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples.Methods: We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities about their experiences and perceptions of participating in biomedical research projects. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work. Results: A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani native community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples in Waorani indigenous people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project.Conclusion: Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological material, including genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.
A genome-wide screening for RNAi pathway proteins in Acari
Authors: Nganso Beatrice T , Sela Noa , Soroker Victoria
Published: October 2020

BackgroundRNA interference (RNAi) is a highly conserved, sequence-specific gene silencing mechanism present in Eukaryotes. Three RNAi pathways are known, namely micro-RNA (miRNA), Piwi-interacting RNA (piRNA) and short interfering RNA (siRNA). However, little knowledge exists about the proteins involved in these pathways in Acari. Moreover, variable successes has been obtained in gene knockdown via siRNA pathway in their functional genomics and management. We hypothesized that the clue may be in the variability of the composition and the efficacy of siRNA machinery among Acari.ResultsBoth comparative genomic analyses and domain annotation suggest that all the analyzed species have homologs of putative core proteins that mediate cleaving of targeted genes via the three RNAi pathways. We identified putative homologs of Caenorhabditis elegans RNA-dependent RNA polymerase (RdRP) protein in all species though no secondary Argonaute homologs that operate with this protein in siRNA amplification mechanism were found, suggesting that the siRNA amplification mechanism present in Acari may be distinct from that described in C. elegans. Moreover, the genomes of these species do not encode homologs of C. elegans systemic RNAi defective 1 (Sid-1) protein that mediate silencing of the mRNA target throughout the treated organisms suggesting that the phenomena of systemic RNAi that has been reported in some Acari species probably occur through a different mechanism. However, Homologs of putative RNAi spreading defective-3 (Rsd-3) protein and scavenger receptors namely Eater and SR-CI that mediate endocytosis cellular update of dsRNA in C. elegans and Drosophila melanogaster were found in Acari genomes. This result suggests that cellular dsRNA uptake in Acari is endocytosis-dependent. Detailed phylogenetic analyses of core RNAi pathway proteins in the studied species revealed that their evolution is compatible with the proposed monophyletic evolution of this group.ConclusionsOur analyses have revealed the potential activity of all three pathways in Acari. Still, much experimental work remains to be done to confirm the mechanisms behind these pathways in particular those that govern systemic/parental RNAi and siRNA amplification in Acari. Disclosure of these mechanisms will facilitate the development of new and specific management tools for the harmful species and enrichment of the beneficial species.
Pulmonary Benign Metastasizing Leiomyomas: a Case Series of 23 Patients at a Single Facility
Authors: Fan Rong , Feng Fengzhi , Yang Hua , Xu Kaifeng , Li Shanqing , You Yan , Wan Xirun , Zhu Lan
Published: October 2020

Background: Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease characterized by leiomyoma of benign histopathology existing in the lungs. Because of its rarity, limited literature with a single case or small number of cases has been regarding to the clinical course, pathology or management of PBML. Methods: A retrospective study was performed of all PBML cases diagnosed and managed at Peking Union Medical College Hospital (PUMCH) from 2001 to 2019. The clinical characteristics, pathology, treatment and outcomes of each case were studied. Results: There were 25 PBML patients identified in the 19-year period in PUMCH, and 23 patients’ data was analyzed. The median age at diagnosis was 46 years. There were 7 patients (30.4%) diagnosed with postmenopausal status. 2 patients (8.7%) had no uterine leiomyoma, and 3 patients (13.0%) had no gynecologic surgery history. Immunohistochemistry of most lesions demonstrated positive for desmin, SMA and Estrogen/Progesterone Receptors; and negative for S-100 were shown in 7 cases. After curative or diagnostic surgeries for the PBML, several treatments from observation to medical or surgical castration were performed. 9 premenopausal patients preserved their ovaries at first. At a median follow-up of 8 years, 3 patients finally had oophorectomy.Conclusions: PBML is a disease that not only be found in premenopausal women. Treatment should be individualized. Curative surgery for patients with limited lesions can achieve the complete response. For patients that are young and asymptomatic, close observation is recommended as the first choice. All patients should undergo long-term surveillance.
Determinants of Hand Hygiene Practice at Critical Times among Food Handlers in Educational Institutions of the Sagnarigu Municipality of Ghana: A Cross-Sectional Study
Authors: Amegah Kingsley E. , Addo Henry O. , Ashinyo Mary E. , Fiagbe Loveland , Akpanya Serene , Akoriyea Samuel K. , Dubik S. Dajaan
Published: October 2020

Introduction: Food handlers’ hands serve as a vehicle for potential foodborne pathogenic contamination which constitutes a public health risk. In Ghana, there are always constant reports of outbreaks of foodborne diseases in schools. However, determinants of hand hygiene practice among educational institutions food handlers are little known. The study, therefore, aimed to assess the determinants of hand hygiene practice at critical times among educational institutions’ food handlers in the Sagnarigu Municipality of Ghana.Methods: This was a cross-sectional survey among educational institutions food handlers in the Sagnarigu Municipality. Two hundred and six food handlers were selected through convenience sampling in the educational institutions. At the same time, structured questions that were developed from previous studies were used to assess food handlers’ hand hygiene practice at critical times. Data were analyzed using descriptive statistics, bivariate and multivariate logistic regression models. All variables with their respective confidence intervals (95%) and adjusted odds ratios were declared significant at P-values less than .05.Results: Hand hygiene practice at critical times among the food handlers were relatively good at a rating of 66.0% (95% CI: 59.1, 72.5%). Good hand hygiene practice at critical times was less likely among food handlers with no food safety training (AOR 0.04; 95% CI: 0.00, 0.41) and food handlers who had insufficient knowledge of hand hygiene (AOR 0.06; 95% CI 0.01, 0.25). Good hygiene practice at critical times was 99% lower in food handlers with a negative attitude as compared to food handlers with positive attitudes towards hand hygiene at critical times (AOR 0.01; 95% CI 0.00, 0.07). Only 17.0% of the food handlers demonstrated proper handwashing techniques, whereas a good number (85.4%) of the food handlers did not wash their hands after touching money. Conclusion: Good hand hygiene practice at critical times was relatively good. Food safety training, knowledge of hand hygiene and attitudes towards hand hygiene were independent predictors of hand hygiene practice at critical times. Concerned stakeholders and organizations should focus on WASH interventions that seek to improve educational institutions food handlers’ knowledge and attitudes towards hand hygiene, coupled with training on food safety.
Supply Versus Demand of Health Care Facilities in a Competitive Context: Case of Tuberculosis Care in Douala-Cameroon.
Authors: Yakam Andre Nana , Koncy Prisca Fosso , Martin Njocke , Samuel Bowong , Louis Fono Aimé , Jürgen Noeske
Published: October 2020

Background: Identifying the socio-economic factors associated with the supply and demand of health facilities (HF), including their spatial model, can contribute to the decision-making of the creation of the HF. This study aims to contribute to this issue in the competitive context of the tuberculosis diagnosis and treatment centres (DTC) in Douala, Cameroon. Methods: The “observed” number of patients attending the DTCs was compared to the “expected” number, using a bivariate analysis. Multivariate analysis using logistic regression and the analysis of variance were used to identify the factors associated to attendance of DTCs. Spatial analysis was performed to access the spatial-economic model hiding behind the distribution of the DTCs.Results: There is a spatial-economic model hiding behind the distribution of DTCs in Douala, which dictate their solicitation. The decentralization policy advocated by the national program against tuberculosis (NTP) is not always followed by the patients: The “expected” and the “observed” number of patients in DTCs are not correlated. Patients seeking treatment in DTCs closer to their residence are mainly women and patients from relative poor households, while attendance of DTC was associated with the quality of serviceConclusion: Attendance HF is dictate by the spatial-economic model. The policy of creating HF for TB is not followed by patients in competitive context. Attendance of HF by TB patients is associated with some socioeconomics factors;
Development of a chiral HPLC method for the separation and quantification of hydroxychloroquine enantiomers
Authors: Xiong Xisheng , Wang Kun , Tang Tao , Fang Jinzhi , Chen Yijun
Published: October 2020

Hydroxychloroquine (2-[[4-[(7-Chloroquinolin-4-yl) amino]pentyl](ethyl) amino]-ethanol, HCQ), an effective anti-malarial drug, has been applied in the clinics for potential treatment of severe coronavirus disease 2019 (COVID-19). Although the clinical benefits of HCQ require extensive clinical data to confirm, the existence of a chiral center in the molecule to possess two optical isomers suggests that there might be an enantiomeric difference on the treatment of COVID-19. Due to poor resolution and the inability of quantification by previously reported methods for the analysis of HCQ enantiomers, it is necessary to develop an analytical method to achieve baseline separation for quantitative and accurate determination of the enantiomeric purity in order to compare the efficacy and toxicity profiles of different enantiomer. In this study, we developed and validated an accurate and reproducible normal phase chiral HPLC method for the analysis of two enantiomers of HCQ, and the method was further evaluated with biological samples. With this newly developed method, the relative standard deviation of all analytes was lower than 5%, and the limit of quantification was 0.27 μg/ml, 0.34 μg/ml and 0.20 μg/ml for racemate, R- and S-enantiomer, respectively. The present method provides an essential analytical tool for preclinical and clinical evaluation of HCQ enantiomers for potential treatment of COVID-19.
Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia
Authors: Scavone Donatella , Sgorbini Micaela , Borges Alexandre Secorun , de Oliveira-Filho Josè Paes , Vitale Valentina , Paltrinieri Saverio
Published: October 2020

Background: Paraoxonase-1 (PON-1) is an antioxidant enzyme, whose activity decreases during the acute phase response in many species. Little is known about PON-1 and its role as a negative acute phase protein during septic inflammation in horses, but promising findings about its utility in diagnosing SIRS and predicting the outcome in diseased horses, were recently highlighted. The objective of the study was to investigate the behaviour of PON-1 in horses after experimentally induced endotoxemia. To this aim, PON-1 activity was measured on 66 plasma samples collected from six clinically healthy mares, previously included in another study, before and at multiple time points between 12 and 240 hours after intravenous infusion of Escherichia coli O55:B5 lipopolysaccharide (LPS). Results: compared with baseline values, a progressive transient decrease of PON-1 activity was observed starting from 24 hours post-infusion, with lowest values observed between 3 to 7 days post-infusion, followed by a normalisation to pre-infusion levels the tenth day.Conclusions: the results of this study suggest that measurement and monitoring of PON-1 activity might be useful to evaluate progression and recovery from endotoxemia in horses. Further studies in horses with naturally occurring sepsis are warranted.
Spring warming drives past and future shifts in Great Plains storm intensity
Authors: Sun Chijun , Shanahan Timothy , DiNezio Pedro , McKay Nicholas , Roy Priyadarsi
Published: October 2020

The climate of the Great Plains is dominated by mesoscale convective systems (MCS), which supply a significant portion of warm season rainfall and are responsible for severe weather and flooding across the region. However, little is known about past behavior and long-term drivers of these systems, limiting our ability to predict future changes in hydroclimate and extreme weather for much of the central US. Here, we generate a new record of past MCS activity and hydroclimate variability from central Texas and compare it against the results of transient climate model simulations to understand the underlying causes of past changes in extreme weather and climate in the central US. We find that changes in storm activity and hydroclimate in the southern Great Plains over the last the 20,000 years were dominated by changes in the strength of the Great Plains Low Level Jet, driven by springtime land surface temperature changes. These results suggest that a similar dynamical response to future warming will lead to enhanced MCS activity and an increase in extreme weather and flooding across the southern and central Great Plains in the future.
Identification of Autophagy-Related Long Non-Coding RNA Prognostic Signature for Clear Cell Renal Cell Carcinoma
Authors: Cui Yankang , Zhang Shaobo , Miao Chenkui , Liang Chao , Chen Xiaochao , Yan Tao , Bu Hengtao , Dong Huiyu , Li Junchen , Li Jie , Wang Zengjun , Liu Bianjiang
Published: October 2020

Background: Studies over the past decade have shown that long non-coding RNAs (lncRNAs) play an essential role in the tumorigenesis and progression of kidney renal clear cell carcinoma (KIRC). Meanwhile, autophagy has been demonstrated to regulate KIRC pathogenesis and targeting therapy resistance. However, the prognostic value of autophagy-related lncRNAs in KIRC patients has not been reported before.Methods: In this study, we obtained transcriptome data of 611 KIRC cases from the TCGA database and 258 autophagy-related mRNAs from the HADb database to identify autophagy-related lncRNAs by co-expression network. A prognostic model was then established basing on these autophagy-related lncRNAs, dividing patients into high-risk and low-risk groups. Survival analysis, clinical variables dependent receiver operating characteristic (ROC) analyses, univariate/multivariate Cox analyses, and clinical correlation analysis were performed based on risk signature with R language. Gene set enrichment analysis (GSEA) was then performed to investigate the potential mechanism of the risk signature promoting KIRC progression with GSEA software. Results: A total of 17 lncRNAs were screened out and all these lncRNAs were found significantly related to KIRC patients' overall survival in subsequent survival analyses. Besides, the overall survival time in the high-risk group was much poorer than in the low-risk group. The ROC analysis revealed that the prognostic value of risk signature was better than age, gender, grade, and N stage. Univariate/multivariate analyses suggested that the risk signature was an independent predictive factor for KIRC patients. Immune-related pathways were dramatically enriched in high-risk patients according to GSEA. Conclusions: In summary, our identified 17 autophagy-related lncRNAs had prognostic value for KIRC patients which may function in Immunomodulation.
Regional Trends and Associated Factors of Childhood Visual Impairment: A Case Study in Shandong Province, China
Authors: Han Lizhen , Jia Jinzhu , Wang Lu
Published: October 2020

Background: Visual impairment is a common child health problem. We hopes to analyze the regional trend, related factors and spatial distribution of children's visual impairment in Shandong province, to explore the spatial changes brought by time and their influencing factors, so as to provide scientific basis for prevention of childhood visual impairment.Methods: This study covers five complete cross-sectional surveys (Physical examination data in Shandong province) from 2013 to 2017, involving about 29.24 million students. The 11th International Classification of Diseases was selected as the diagnostic standard. Spatial autocorrelation and hotspot analysis methods in ArcGIS software were used to analyze spatial features. The associated factors were analyzed by multinomial logistic regression.Results: The visual impairment prevalence showed a trend of decreasing first and then increasing from 2013-2017, with slight changes. In terms of regional spatial differences, Weihai and Yantai have the highest VI rates in all years, and there was a large-scale spatial aggregation phenomenon. The southern low-value clusters, however, showed a weakening year by year. Further exploration revealed that the per capita disposable income of rural households, the growth rate of gross domestic product, total retail sales of consumer goods and number of full-time teachers were verified as risk factors for regional visual impairment levels.Conclusions: The slight rebound of the prevalence of visual impairment and the high rate in the eastern and northern regions of Shandong province need more attention. It is suggested that relevant departments should focus on the influence of regional economic and educational factors when formulating relevant strategies.
Heat Shock Modulates The Expression of Sirtuins and Var Genes in The Malaria Parasite Plasmodium Falciparum
Authors: Anagu Linda O. , Hulse David R. , Chakravorty Srabasti J , Horrocks Paul D. , Merrick Catherine Jill
Published: October 2020

Background: In the malaria parasite Plasmodium falciparum the expression of ‘var’ virulence genes is regulated through epigenetic mechanisms. Two deacetylase enzymes of the sirtuin family have been implicated in this epigenetic control in laboratory-adapted parasites. A previous study of var gene expression in parasites isolated directly from Gambian malaria patients found that high expression levels of severe-disease-associated var variants correlated with high expression of the PfSir2A sirtuin, and these expression patterns also correlated with patient phenotypes of fever and hyperlactataemia. Together, the observations suggest a mechanism through which stress phenotypes in the human host might be sensed via a parasite sirtuin, and virulence gene expression modulated accordingly. Methods: In vitro experiments were conducted using recently-laboratory-adapted Kenyan isolates of P. falciparum to follow up the correlative findings of the field study. To investigate a potential cause-and-effect relationship between host stress factors and parasite gene expression, qPCR was used to measure the expression of sirtuins and var genes after cultured parasites had been exposed to 2h or 6h of heat shock at 40°C or elevated lactate at 5mM.Results: Heat shock was shown to influence the expression of both sirtuins and var genes, whereas exposure to lactate was not. Heat shock in the trophozoite stage resulted in modest upregulation of the expression of sirtuins, particularly PfSir2B, by 2-3 fold in all strains tested. Interestingly, when heat shock was applied in ring stages PfSir2A was still upregulated but PfSir2B was downregulated. This correlated with a general upregulation of ring-stage var transcription, and particularly of severe-disease-associated upsA and upsB var genes, but there was no clear pattern in the dominant var gene(s) ultimately expressed by heat-shocked parasites. Conclusions: This study demonstrates for the first time that heat stress in recently-laboratory-adapted isolates of P. falciparum results in altered sirtuin expression – PfSir2B as well as PfSir2A – and also the upregulation of var gene expression. These may be strategies evolved by the parasite to survive heat stress when a human host experiences malarial fevers. By contrast, the association between hyperlactataemia and sirtuin/var gene expression that was previously observed in vivo appears to be coincidental rather than causative.
ISRIB prevents synaptic plasticity disruption and cognitive deficits in live rat model of Alzheimer’s disease
Authors: Hu Neng-Wei , Hu Zhengtao , Yu Pengpeng , Wang Deguo , Wu Yong , Qi Yingjie , Ondrejcak Tomas , Klyubin Igor , Xu Jitian , Yang Yin , Rowan Michael J.
Published: October 2020

BackgroundGrowing evidence shows that targeting the integrated stress response (ISR) through the inhibition of phosphorylation of eIF2α provides beneficial effects in animal models of neurodegenerative diseases including Alzheimer’s disease (AD). However, those results are inconsistent and somehow conflicting likely due to the important role of ISR in both cell death and survival. Aβ-triggered pathologies including microvascular hypoxia, neuronal hyperactivation, neuroinflammation are common inducers of the ISR. The small-molecule inhibitor of the ISR called ISRIB, which only partially restores protein synthesis and confers neuroprotection without adverse effects on the pancreas most probably due to its state-dependent action, remarkably enhances cognition in animals.MethodsTo elucidate the roles of ISR in AD pathogenesis, we systemically treated exogenous Aβ-injected animals with ISRIB. Both Aβ-facilitated long-term depression (LTD) and Morris water maze were used to characterize Aβ-induced dysfunction. ResultsAcute treatment with ISRIB prevented Aβ-facilitated LTD and repeated treatment abrogated the spatial learning and memory deficits in exogenous Aβ-injected animals. Moreover, ISRIB restored aberrant high level of ATF4 to normal but did not affect the aberrant high level of phosphorylated eIF2α in the hippocampus of exogenous Aβ-injected rats. ConclusionsTargeting the ISR by suppressing the eIF2α cascade with ISRIB may provide protective effects against the synaptic and cognitive disruptive effects of Aβ which likely mediate the early stage of sporadic AD.
A Systematic Review of the Health Worker-Patient Relationship in China
Authors: Mao Ying , Ning Wei , Zheng Junyao , Zhang Ning , Xie Tao , Liu Jinnan , Lu Yongbo , He Rongxin
Published: October 2020

BackgroundWith a surge of medical disputes in recent years, the health worker-patient relationship (HWPR) in China is presently in a tense situation. Meanwhile, consequent social problems have begun to emerge, such as the practice of defensive medicine and distrust between health workers and patients. Although many empirical studies about the HWPR have been conducted in China, no related systematic reviews have been found. This study can convey the general findings from China to other areas of the world.MethodsA systematic review and meta-analysis of the HWPR and related determinants were conducted. Six databases were comprehensively searched for articles to include in the review, with no restrictions on language. Articles published between January 1, 2000 and January 1, 2020 were included.ResultsAmong the 3,290 records initially identified, 11 studies met the selection criteria. A total of 96,906 individuals were included in the review. The meta-analysis indicated that health workers who were male (male vs. female, OR: 1.48, 95% CI: 1.42- 1.55), older (≤50 vs. >50, 0.86, 0.80-0.93), less educated (undergraduate or below vs. masters or above, 1.39, 1.21-1.60), working in a non-surgical department (surgery vs. other, 0.92, 0.88-0.96), and had a senior title (intermediate or below vs. senior, 0.77, 0.74-0.81) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Patients who were rural residents (urban vs. rural, 0.92, 0.87-0.97), highly educated (below undergraduate vs. undergraduate or above, 0.75, 0.72-079), and had no medical insurance (medical insurance vs. no medical insurance, 0.77, 0.67-0.89) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Furthermore, mutual trust could improve rapport between health workers and patients. The 25 other related factors were analysed and described using a narrative approach.ConclusionOn average, 55.73% of health workers consider the HWPR to be tense, which is higher than the proportion of patients who hold this view (33.7%). The HWPR was significantly associated with individual factors and socioeconomic factors of both health workers and patients, as well as factors related to the health worker-patient interaction. More targeted strategies should be developed to improve the HWPR.
Microstructure and Mechanical Properties of C/C Composites with Different Configuration of Unidirectional Macropores
Authors: Jia Jiangang , Ju Jiakang , Liu Shunwei , Ji Genshun
Published: October 2020

The unidirectional porous C/C composites with different channel-diameter and channels-row spacing were prepared by a space-holder route. The effects of different channel-diameter and channels-row spacing on the mechanical properties and microstructures of the porous C/C composites were studied. Results show that increasing the channel-diameter or reducing the channels-row spacing helps to obtain finer PyC grains but significantly reduce the matrix density of the composites, and, in turn, the compressive strength of the composites. Porous C/C composites with lower porosity or higher density (e.g., S5,2) present relatively high strength, whereas C/C porous composites with lower density or higher porosity show a pseudo-plastic fracture mode and relatively lower strength. The compression strength in the load parallel to channel direction is higher than that in the load perpendicular to channel direction of the same composite.
A Study on the Influence of Project Leadership on Project Management and Performance
Authors: Theophanus Momanyi N.
Published: October 2020

The current study was a survey into the issue of project leadership influence on project management and performance. It has objectively focused on effects of leadership skills, experience, quality and styles in enhancing project performance. Further, the study sought to answer questions on the impact of aligning, motivating, directing and influencing in enhancing project performance. Apart from conducting a review of past studies, theoretical foundations were also reviewed to underpin the hypotheses that guided the study. Quantitative data was collected using structured questionnaires and analysed descriptively. Further, regression analyses were done and results confirmed a positive and strong connection concerning leadership components and management functions on project performance. From obtained outcomes, recommendations are given for future studies to focus on, as well as for improvement in different industries while implementing various projects.
Health Outcomes of Sexual and Gender Minorities After Cancer: A Scoping Review
Authors: Pratt-Chapman Mandi , Rodriguez-Diaz Carlos E. , Alpert Ash
Published: October 2020

Purpose: Cancer research on sexual and gender minority (SGM) populations is gaining momentum. However, literature on patient-reported health outcomes for SGM people with a history of cancer is limited. The purpose of this review was to examine the nature and extent of research regarding patient-reported health outcomes after cancer treatment among SGM populations. Methods: A systematic search of key words, titles, abstracts, and/or major subjects was conducted in PubMed, Scopus, and CINAHL in September 2019 and in EMBASE in February 2020. Included studies investigated at least one physical, psychosocial, emotional, or functional patient-reported outcome related to cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, assessed for quality, and trends within and across studies were reported in addition to each study’s results. Results: Fifty-two studies were included in the final analysis; most were quantitative and focused on people with a history of breast and prostate cancer. Most studies were secondary analyses or cross-sectional studies of convenience samples, limiting generalizability. Conclusions: A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. Implications for cancer survivors: Sexual orientation and gender identity are relevant to cancer survivors’ health outcomes. Clinicians and researchers can build an evidence base to inform care improvements by collecting data on anatomy, sexual orientation, and gender identity in Electronic Health Records and population-based surveys.
Finite Element Analysis of Necessity of Reduction and Selection of Internal Fixation for Valgus-impacted Femoral Neck Fracture
Authors: Dai Yahui , Ni Ming , Dou Bang , Wang Zhiyuan , Zhang Yushan , Cui Xueliang , Ma Wenqian , Qin Tao , Xu Xiaobin , Mei Jiong
Published: October 2020

BackgroundAlthough valgus-impacted fractures don’t displace obviously, a larger valgus angle and posterior tilt of the femoral head can cause hip joint dysfunction and femoral head necrosis. The optimal surgical approach for valgus-impacted femoral neck fractures remains controversial. This study compared the biomechanical characteristics of different treatment strategies based on finite element analysis.MethodsTen valgus-impacted femoral neck fractures were analyzed in terms of posterior tilt and valgus angle measured on X-ray radiographs. Using these data, we generated 7 finite element models that were compared in terms of von Mises stress distribution and displacement.ResultsIn the intact femur, von Mises stress was concentrated at the medial and inferior sides of the femoral neck. In valgus-impacted femoral neck fractures, von Mises stress was at the same locations but was 5.66 times higher than that in the intact femur. When 3 cannulated screws were used for internal fixation, anatomic reduction diminished the stress at the fracture end from 140.6 to 59.14 MPa, although displacement increased from 0.228 to 0.450 mm. When the fracture was fixed with a sliding hip screw (SHS) + cannulated screw, there was less stress at the fracture end and greater displacement with anatomic reduction than that without reduction (stress: 15.9 vs 37.9 MPa; displacement: 0.329 vs 0.168 mm).ConclusionsThe SHS + cannulated screw has superior biomechanical stability than 3 cannulated screws, and is recommended following anatomic reduction to treat valgus-compacted femoral neck fractures.
Retrospective Analysis of Traumatic Triradiate Cartilage Injury in Children
Authors: Dong Yao , Wang Jinkui , Qin Jiaqiang , Nan Guoxin , Su Yuxi , He Bo , Cai Wenquan , Chen Kai , Gu Kai , Liang Xun , Yan Ge , Wang Zhongliang
Published: October 2020

Background: To summarize and analyze the epidemiological characteristics, treatment and corresponding curative effect of triradiate cartilage injury(TCI) in children after trauma, to provide a theoretical basis for early diagnosis and improvement of treatment. Methods: The TCI was classified according to our modified Bucholz classification (type IV and VI were added), and the final curative effect was evaluated with Harris Hip Score and imaging examination during follow-up. Finally, a comprehensive analysis was made by reviewing the cases in the literature combined with the patients in our hospital. Results: A total of 15 cases (18 hips) of triradiate cartilage injuries were collected in our hospital. There was one hip with type I injury, nine hips with type II injury, two hips with type IV injury, one hip with type V injury and five hips with type VI injury. Among the 12 cases with complete follow-up, the bone bridge was found in or around the triradiate cartilage in 8 cases，early fusion of triradiate cartilage occurred in 5 patients, 3 cases had hip dysplasia, 4 cases had a subluxation of the femoral head, and HHS was excellent in 8 cases and good in 4 cases.Conclusion: The early diagnosis of TCI is still a quite challenging issue. Conservative treatment is often the first choice. The overall prognosis of acetabular fractures involving triradiate cartilage is poor. The formation of the bone bridge in triradiate cartilage usually indicates the possibility of premature closure, which may lead to acetabular dysplasia. Level of evidence IV: Retrospective case series
The Transfer Paths’ Contribution Analysis to Floor Vibration of Metro Vehicle
Authors: laixian peng , Nie Jiaxing , Han Jian , Mi Caiying
Published: October 2020

Noise control is one of key issues to improve the ride comfort of metro trains. To find out the excitation source and its transfer path is an important prerequisite for noise control. The sound source identification results found that the significant noise source in metro trains is the structural-borne sound radiated by floor vibration. Based on the OTPA method, this study presents a method considering the amplitude and phase of the excitation to analyze the contribution of the secondary suspension path to the floor vibration. The results show that the energy of the passenger room noise mainly concentrates on the frequency range of 300~800Hz, caused by floor vibration; in the frequency range of 300~800Hz, the vertical direction of the anti-rolling torsion bar area provides the maximum contribution to the floor vibration, followed by the longitudinal direction of the air spring area. On the basis of contribution analysis, a transfer path optimization scheme is proposed, which may provide reference for future metro trains noise control.
Method for diagnosing the ICE cylinder-piston group in the combustion chamber in the mode of cranking the engine crankshaft
Authors: Gritsenko Alexandr , Shepelev Vladimir , Baryshnikov Sergey
Published: October 2020

To increase the diagnostic efficiency, significantly reduce the unproductive time, and mainly increase the reliability and accuracy, we propose a new method and tools implementing it - an oscillographic method for monitoring the pressure and phase parameters during the dynamic change in the operating parameters. The proposed work is aimed at improving the internal combustion engine (ICE) performance by timely diagnosing the cylinder-piston group (CPG) and its maintenance based on the diagnostic results. The scientific novelty of the work lies in the establishment of the interconnection of the CPG parameters obtained in the test modes of the ICE operation, allowing us to justify the diagnostic modes and their limiting values; the development of diagnostic methods and tools allowing us to justify the test modes for diagnosing the ICE CPG; the experimental data, which revealed that the instantaneous pressure signal in the combustion chamber is a sensitive diagnostic sign, which reflects the technical condition of the ICE CPG and its elements; the results of the experimental studies of diagnosing the ICE CPG in test modes. The results of the experimental work were compared with the results of theoretical modeling, the convergence between them was 97–99%. The production validation of the new method demonstrated the reliability within 0.92–0.97.