bluuebunny/crossref_metadata_2025 huggingface dataset:
Escherichia Coli Subscapular Abscess as a Rare Complication of Manual Therapy in Frozen Shoulder: A Case Report
Authors: Ham Dong Hun , Wang Sungil
Published: January 2021

Background: Subscapular abscess is a rare condition usually secondary to immunocompromised state and recent infection. Staphylococcus aureus (S. aureus) is the most common etiologic agent. To the best of our knowledge, we present the first case of a patient with a frozen shoulder performing manual therapy, which resulted in an Escherichia coli subscapular abscess.Case presentation: A 72-year-old male was referred from the respiratory department with pain and a limited range of motion in the left shoulder. He complained that the pain was exacerbated with popping sound during manual therapy for frozen shoulder two weeks ago. Magnetic resonance imaging revealed a large intramuscular complicated fluid collection at the level of the subscapularis muscle 10.0 × 5.2 × 11 cm in size, and a bloody but turbid pus-like discharge was observed upon aspiration. He underwent urgent surgical drainage. The cultures from the abscess fluid revealed extended-spectrum beta-lactamases (-) E. coli. After 4 weeks of Ceftazidime intravenous treatment, symptoms of the patient had improved. Conclusions: This case highlights the risks of aggressive manual therapy in severe frozen shoulder. It also presents a clinical scenario in which practitioners of manual therapy in frozen shoulder should be aware of the risk of subscapular abscess in patients undergoing recent infection therapy
17 Years Successional Enrichment Plantation of Tree Recruitment and Restoration in Tropical Forestland
Authors: Omomoh Bernard Eromosele , Adekunle Victor AJ
Published: January 2021

BackgroundWe examine the recruitment drive of overstorey and undergrowth of tropical forested reserve by assessing the tree diversity, species composition, species richness, and growth form of the undergrowth on 17 years of post-disturbance. ResultThe result show an increase in the diversity and even distribution of the species of the overstorey, compared to the undergrowth. Conversely, the overstorey has a lower in species richness as compared to the level of undergrowth. One way ANOVA results shows that there is no significant difference (P = 0.341). However, undergrowth density (individual/ha) is found to be significantly (P = 0.000) higher than the overstorey trees.Conclusions﻿It is evident that the forest trees and saplings are dissimilar in species abundance, which implies that sapling recruitment is a key determinant of the tree species composition of the forest. It is then concluded that the method adopted for restoration encouraged species diversity in this successional forest.
Ginkgo Biloba Extract 761 Reduces Vascular Permeability of the Ovary and Improves the Symptom of Ovarian Hyperstimulation Syndrome in a Rat Model
Authors: Zhang Jie , Huang Jie , He Xinhuan , Li Ning , Miao Yu , Li Beiqing , Shao Xiaoguang , Wang Ningning
Published: January 2021

BackgroundGinkgo biloba extract (EGb) has been widely applied in the treatment of cerebrovascular and neurological diseases. However, the effect of EGb761 on ovarian hyperstimulation syndrome (OHSS), a vascular disorder and life-threatening complication of In vitro fertilization and Intracytoplasmic sperm injection therapy (IVF/ICSI), has not been evaluated. MethodsForty female Wistar rats aged 22-days old (D22) were divided into eight groups: Control rats received intraperitoneal injection of saline for 5 consecutive days (D22-D26); OHSS-model group received 10 IU equine chorionic gonadotropin (eCG) for 4 consecutive days (D22-D25) and 30 IU of human chorionic gonadotropin (hCG) on the 5th day (D26); Prophylactic treatment group received three doses of EGb761 (50mg/kg/d, 100mg/kg/d, 200mg/kg/d) one hour before injection of eCG (hCG) for 7 consecutive days; Therapeutic treatment group received three doses of EGb761 (50mg/kg/d, 100mg/kg/d, 200mg/kg/d) 48 hours after injection of eCG (hCG) for 7 consecutive days. ResultsWe found the therapeutic treatment group exhibited the lowest ovarian and renal mass index, vascular permeability, estradiol and progesterone concentrations, vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR) protein expression. ConclusionsEGb761 decreases vascular permeability in OHSS rat model by inhibiting VEGF and VEGFR expression, which may contribute to the prevention and treatment of OHSS. Furthermore, therapeutic medication is superior to prophylactic medication.
Chronic Pain Has Little Effect on Physical Condition During the COVID-19 Pandemic in Japan: A Web-based Cross-Sectional Survey
Authors: Tetsunaga Tomoko , Tetsunaga Tomonori , Misawa Haruo , Tsuji Hironori , Ozaki Toshifumi , Tabuchi Takahiro
Published: January 2021

Background Chronic pain affects people negatively, both mentally and physically. It is unclear how chronic pain affects people during social isolation and remote work due to the COVID-19 pandemic. The aim of this study was to analyze the effect of chronic pain on life during the COVID-19 pandemic.Methods This retrospective study included 4,972 matched-participants with or without chronic pain (2,311 males, 2,661 females; mean age, 53.8 years). The participants were divided into a chronic pain group (n=2,486) and a control group (n=2,486). Participants with chronic pain for three months or more were classified into the chronic pain group. All participants completed self-reported questionnaires. Factors related to physical condition during the COVID-19 pandemic were identified by univariate and multivariate analyses.Results Significant differences were found between participants with and without chronic pain for the pain that developed during the COVID-19 pandemic, lifestyle, interpersonal relationships, psychological factors related to COVID-19, and deterioration of physical condition. Multiple logistic regression analysis identified insomnia, poor work/study/housework performance, and anxiety/depression as factors related to deterioration of physical condition. Chronic pain was not identified as factor related to deterioration of physical condition.Conclusions The effect of chronic pain on lifestyle and physical condition during the COVID-19 pandemic was limited. The factors related to deterioration of the physical condition were insomnia, poor work/study/housework performance, and anxiety/depression.
Exploring health-seeking behaviour among adolescent mothers during the Ebola epidermic in rural district of Freetown, Sierra Leone
Authors: Massaquoi Hamida , Atuhaire Catherine , Chinkonono Gorgeous Sarah , Christensen Betty Nyawira , Bradby Hannah , Cumber Samuel Nambile
Published: January 2021

Background: From 2014-2016, the largest Ebola outbreak in history threatened Sierra Leone and its neighbouring countries, Guinea and Liberia. The Ebola outbreak impacted pregnant adolescent girl’s access to prenatal care during the pandemic. The aim of this study is to understand health-seeking behaviour among adolescent mothers who were pregnant during the Ebola epidemic in Waterloo, Sierra Leone. Methods: The present qualitative study uses the “Three Delay” model, as a theoretical framework to understand and explore adolescent mother’s health-seeking behaviour through four focus group discussions with five participants in each discussion group. The data were analysed using thematic analysis. Results: A multitude of challenges were identified following the Ebola epidemic. The fear of contracting Ebola was a common reason for not seeking care or utilising services. This notion was perpetuated by perceptions in the community and participants personal experiences. Quarantines, national lockdowns, roadblocks, loss of income and extreme poverty were also identified as barriers to accessing health facilities during Ebola. The different encounters with health workers and the challenges that arose at the health facilities were subsequently additional discouraging factors influencing participant’s decision not to seek health care. Conclusion: Many of the pre-existing maternal health, societal and social-economic challenges were exacerbated during the Ebola. The epidemic also contributed new challenges such as public fear, mistrust towards health professionals and the health system. Greater emphasis needs to be placed on improving maternal care in general, but also improving preparedness for maternal care in case of future outbreaks, especially for the most vulnerable groups such as adolescent mothers
Qualitative evaluation of the Autism Behavior Inventory: Use of cognitive interviewing to establish validity of a caregiver report scale for autism spectrum disorder
Authors: Pandina Gahan , Ness Seth , Trudeau Jeremiah , Stringer Sonja , Knoble Naomi , Lenderking William R. , Bangerter Abigail
Published: January 2021

Purpose: The Autism Behavior Inventory (ABI) is an observer-reported outcome scale measuring core and associated features of autism spectrum disorder (ASD). Extensive scale development (reported elsewhere) took place, in alignment with the Food and Drug Administration’s patient-reported outcome guidance, to address the need for instruments to measure change and severity of ASD symptoms. Methods: Cognitive interviewing was used to confirm understanding and content validity of the scale prior to its use in clinical trials. Respondents were caregivers of individuals with ASD (N=50). Interviews used a hybrid of the “think-aloud” and verbal probing approach to assess ABI’s content validity and participant understanding of the instrument, including: item clarity and relevance; item interpretation; appropriateness of response scales; and clarity of instructions. Audio-recordings of the interviews were transcribed for qualitative data analysis. The scale was revised based on participant feedback and tested in a second round of interviews (round 1 N=38, round 2 N=12)Results: In total, 67/70 items reached ≥90% understandability across participants. Caregivers were able to select an appropriate response from the options available and reported finding the examples helpful. Based on participant feedback, instructions were simplified, 8 items were removed, and 10 items were reworded. The final revised 62-item scale was presented in round 2, where caregivers reported readily understanding the instructions, response options, and 61/62 items reached ≥90% understandability.Conclusions: Cognitive interviews with caregivers of a diverse sample of individuals with ASD confirm the content validity and relevance of the ABI to assess core and associated symptoms of ASD.
An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
Authors: Sami Samira , Amsalu Ribka , Dimiti Alexander , Jackson Debra , Kenneth Kemish , Kenyi Solomon , Meyers Janet , Mullany Luke C , Scudder Elaine , Tomczyk Barbara , Kerber Kate
Published: January 2021

Background: In South Sudan, the civil war in 2016 led to mass displacement in Juba that rapidly spread to other regions of the country. Access to health care was limited because of attacks against health facilities and workers and pregnant women and newborns were among the most vulnerable. Translation of newborn guidelines into public health practice, particularly during periods of on-going violence, are not well studied during humanitarian emergencies. During 2016 to 2017, we assessed the delivery of a package of community- and facility-based newborn health interventions in displaced person camps to understand implementation outcomes. This case analysis describes the challenges encountered and mitigating strategies employed during the conduct of an original research study. Discussion: Challenges unique to conducting research in South Sudan included violent attacks against humanitarian aid workers that required research partners to modify study plans on an ongoing basis to ensure staff and patient safety. South Sudan faced devastating cholera and measles outbreaks that shifted programmatic priorities. Costs associated with traveling study staff and transporting equipment kept rising due to hyperinflation and, after the July 2016 violence, the study team was unable to convene in Juba for some months to conduct refresher trainings or monitor data collection. Strategies used to address these challenges were: collaborating with non-research partners to identify operational solutions; maintaining a locally-based study team; maintaining flexible budgets and timelines; using mobile data collection to conduct timely data entry and remote quality checks; and utilizing a cascade approach for training field staff. Conclusions: The case analysis provides lessons that are applicable to other humanitarian settings including the need for flexible research methods, budgets and timelines; innovative training and supervision; and a local research team with careful consideration of sociopolitical factors that impact their access and safety. Engagement of national and local stakeholders can ensure health services and data collection continue and findings translate to public health action, even in contexts facing severe and unpredictable insecurity.
Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China
Authors: Zhao Huiying , Wang Guangjie , Lyu Jie , Zhang Xiaohong , An Youzhong
Published: January 2021

Background: Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.Methods: The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. PMV was defined as a mechanical ventilation length of more than 24 hours. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.Results: Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P<0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.Conclusions: Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.
Vancomycin-lock therapy for prevention of catheter-related bloodstream infection in very low body weight infants
Authors: Liang Hong , Zhang Lian , Guo Xiaoping , Sun Li
Published: January 2021

Background: This study was to evaluate the effectiveness and safety of vancomycin- lock therapy for the prevention of catheter-related bloodstream infection (CRBSI) in very low body weight (VLBW) preterm infant patients. Methods: One hundred and thirty-seven cases of VLBW preterm infants who retained peripherally inserted central catheters (PICCs) were retrospectively reviewed, including 68 treating with heparin plus vancomycin (vancomycin-lock group) and 69 with heparin only (control group). The incidence of CRBSI, related pathogenic bacteria, adverse events during the treatment, complications, antibiotic exposure, PICC usage time, hospital stay, etc. were compared between the above two groups. Results: The incidence rate of CRBSI in the vancomycin-lock group (4.4%, 3/68) was significantly less than in the control group (21.7%, 15/69, p=0.004). Total antibiotic exposure time during the whole observation period was significantly shorter in the group than in the control group (11.2±10.0 vs 23.6±16.1 d; p<0.001). No hypoglycemia occurred during the locking, and the blood concentrations of vancomycin were not detectable. Conclusions: Vancomycin-lock may effectively prevent CRBSI in Chinese VLBW preterm infants and reduce the exposure time of antibiotics, without causing obvious side complications.
miR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4miR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4
Authors: Lin Bo , Shi Enyi , Jin Qiu , Zhao Wenhui , Wang Juan , Ji Runyuan
Published: January 2021

Background: Dysregulation of miRNAs is involved in carcinogenesis of breast and may be used as prognostic biomarkers and therapeutic targets during cancer process. The purpose of this study was to explore the effect of miR-105-3p on tumourigenicity of breast cancer and its underlying molecular mechanisms.Methods: Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was applied to detect the expression of miR-105-3p in breast cancer tissues and cell lines. The impacts of miR-105-3p on proliferation, migration, invasion and apoptosis of human breast cancer cells (MCF-7 and ZR-75-30) were evaluated by CCK-8, transwell chamber assay, TUNEL assay and western blot assay, respectively. Besides, bioinformatics and luciferase reporter assay were used to find out the target genes of miR-105-3p.Results: The expression of miR-105-3p was elevated in breast cancer tissues and increased along with tumor severity. Downregulation of miR-105-3p could inhibit cell proliferation, suppress cell migration/invasion, and promote cell apoptosis in MCF-7 and ZR-75-30 cells. Furthermore, Golgi integral membrane protein 4 (GOLIM4) was identified to be the direct target gene of miR-105-3p by bioinformatics and luciferase reporter assay. In addition, silencing of GOLIM4 could restore the anti-breast cancer effects induced by miR-105-3p downregulation.Conclusions: MiR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4, which provides a new target for the prevention and treatment of breast cancer.
Prognostic role of preoperative D-dimer, fibrinogen and platelet levels in patients with oral squamous cell carcinoma
Authors: Liang Yu-jie , Mei Xue-ying , Zeng Bin , Zhang Si-en , Yang Le , Lao Xiaomei , Liao Gui-qing
Published: January 2021

Background: The relationship between cancer and coagulation has been intensively studied in recent years; however, the effects of coagulation factors on oral squamous cell carcinoma (OSCC) have rarely been reported. This study aimed to investigate the relationship between preoperative D-dimer (DD), fibrinogen (FIB), platelets (PLT) and OSCC, as well as the prognostic value of DD, FIB and PLT in OSCC.Methods: We retrospectively investigated a total of 202 patients with OSCC treated at Guanghua Hospital of Stomatology, Sun Yat-sen University. Baseline demographic and clinicopathological information as well as both preoperative and postoperative DD, FIB and PLT results were collected from each patient, and all patients were followed up for disease progression, death or the end of the study. The correlations between preoperative DD, FIB, PLT and other clinical features, as well as the therapeutic effect and PFS were analysed statistically, and postoperative DD and surgical parameters were also analysed.Results: Preoperative DD was significantly correlated with T stage, N stage, clinical stage and relapse of OSCC (P=0.000, 0.001, 0.000 and 0.000, respectively). Univariate and multivariate Cox regression analyses showed that high preoperative DD independently predicted poor prognosis in patients with OSCC (r=2.1, P=0.033), while FIB and PLT showed no prognostic values. Postoperative DD was significantly correlated with preoperative DD and surgical type but not the duration of surgery (P=0.005, 0.001 and 0.244, respectively).Conclusion: In this study, we suggested that high preoperative DD level may serve as an indicator for synchronous neck dissection in patients with T1,2 OSCC, and the elevated DD level might be the marker of disease progression in patient follow up.
Predicting the Incidence of Brucellosis in Western Iran using Markov switching model
Authors: Mohammadian-Khoshnoud Maryam , Sadeghifar Majid , Cheraghi Zahra , Hosseinkhani Zahra
Published: January 2021

ObjectiveBrucellosis is a zoonosis almost chronic disease. Brucellosis bacteria can remain in the environment for a long time. Thus, climate irregularities could pave the way for the survival of the bacterium Brucellosis. Brucellosis is more common in men 25 to 29 years of age, in the western provinces, and in the spring months. The aim of this study is to investigate the effect of climatic factors as well as predicting the incidence of Brucellosis in Qazvin province using the Markov switching model (MSM). This study is a secondary study of data collected from 2010 to 2019 in Qazvin province. The data include Brucellosis cases and climatic parameters. Two state MSM with time lags of 0, 1 and 2 was fitted to the data. The Bayesian information criterion (BIC) was used to evaluate the models.ResultsAccording to the BIC, the two-state MSM with a one-month lag is a suitable model. The month, the average-wind-speed, the minimum-temperature have a positive effect on the number of brucellosis, the age and rainfall have a negative effect. The results show that the probability of an outbreak for the third month of 2019 is 0.30%.
The implications of clinical risk factors, CAR index, and compositional changes of immune cells on hyperprogressive disease in non-small cell lung cancer patients receiving immunotherapy
Authors: Kim Seo Ree , Chun Sang hoon , Kang Jin-Hyoung , Kim Joo ri , Kim Sang-Yeob , Seo Jun young , Jung Chan Kwon , Gil Bo-Mi , Kim Jeong-Oh , Ko Yoon Ho , Woo In Sook , Shim Byoung Yong , Hong Sook-Hee
Published: January 2021

Background: Immune checkpoint blockades (ICBs) are characterized by a durable clinical response and better tolerability in patients with a variety of advanced solid tumors. However, we not infrequently encounter patients with hyperprogressive disease (HPD) exhibiting paradoxically accelerated tumor growth with poor clinical outcomes. This study aimed to investigate implications of clinical factors and immune cell composition on different tumor responses to immunotherapy in patients with non-small cell lung cancer (NSCLC).Methods: This study evaluated 231 NSCLC patients receiving ICBs between January 2014 and May 2018. HPD was defined as a >2-fold tumor growth kinetics ratio during ICB therapy and time-to-treatment failure of ≤ 2 months. We analyzed clinical data, imaging studies, periodic serologic indexes, and immune cell compositions in tumors and stromata using multiplex immunohistochemistry.Results: Of 231 NSCLC patients, PR/CR and SD were observed in 50 (21.6%) and 79 (34.2%) patients, respectively and 26 (11.3%) patients met the criteria for HPD. Median overall survival in poor response groups (HPD and non-HPD PD) was extremely shorter than region disease-controlled group (SD and PR/CR) (5.5 and 6.1 months vs. 16.2 and 18.3 months, respectively, P= 0.000). In multivariate analysis, HPD were significantly associated with heavy smoker (p=0.0072), PD-L1 expression ≤1% (0.0355), and number of metastatic site ≥3 (0.0297). Among the serologic indexes including NLR, PLR, CAR, and LDH, only CAR had constantly significant correlations with HPD at the beginning of prior treatment, immunotherapy, and at the 1st tumor assessment. The number of CD4+ effector T cells and CD8+ cytotoxic T cells, and CD8+/PD-1+ tumor-infiltrating lymphocytes (TIL) tended to be smaller, especially in stromata of HPD group. More M2-type macrophages expressing CD14, CD68 and CD163 in the stromal area and markedly fewer CD56+ NK cells in the intratumoral area were observed in HPD group.Conclusions: Our study suggests that not only clinical factors including heavy smoker, very low PD-L1 expression, multiple metastases, and CAR index, but also fewer CD8+/PD-1+ TIL and more M2 macrophages in the tumor microenvironment are significantly associated with the occurrence of HPD in the patients with advanced/metastatic NSCLC receiving immunotherapy.
Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients
Authors: Hofmänner Daniel A , Garcia Pedro D Wendel , Duvnjak Branko , Chakrakodi Bhavya , Maier Julian D , Huber Michael , Huder Jon , Wolfensberger Aline , Schreiber Peter W , Schüpbach Reto A. , Zinkernagel Annelies S , Bühler Philipp K , Brugger Silvio D
Published: January 2021

Background: In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission.Methods: Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients.Results: A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards.Conclusions: After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.
Isolating the Energetic and Mechanical Consequences of Imposed Reductions in Ankle and Knee Flexion during Gait.
Authors: McCain Emily , Libera Theresa , Berno Matthew , Sawicki Gregory , Saul Katherine , Lewek Michael
Published: January 2021

Background: Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties.Methods: We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N=15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s-1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (restricted-ank), knee motion (restricted-knee), and ankle and knee motion (restricted-a+k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unrestricted (braced).Results: When ankle motion was restricted (restricted-ank, restricted-a+k) we observed decreased peak propulsion relative to the braced condition on the restricted limb. Reduced knee motion (restricted-knee, restricted-a+k) increased restricted limb circumduction relative to the restricted-ank condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the restricted-ank condition but decreased in the restricted-a+k and restricted-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (restricted-ank) or in addition to knee restriction (restricted-a+k) yielded significant increase in net metabolic rate when compared with the braced condition. Furthermore, the relative increase in metabolic cost was significantly larger with restricted-a+k when compared to restricted-knee condition.Conclusions: Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation.
Morphological characterization and genetic diversity analysis of Tunisian durum wheat (Triticum turgidum var. durum) accessions
Authors: Ouaja Maroua , Bahri Bochra Amina , Aouini Lamia , Ferjaoui Sahbi , Medini Maher , Marcel Thierry , Hamza Sonia Mihed
Published: January 2021

Background: Tunisia is considered a secondary center of diversification of durum wheat and has a large number of abandoned old local landraces. An accurate investigation and characterization of the morphological and genetic features of these landraces would allow their rehabilitation and utilization in wheat breeding programs. Here, we investigated a diverse collection of 304 local accessions of durum wheat collected from five regions and three climate stages of central and southern Tunisia. Results: Durum wheat accessions were morphologically characterized using 12 spike- and grain-related traits. A mean Shannon-Weaver index (H') of 0.80 was obtained, indicating high level of polymorphism among accessions. Based on these traits, 11 local landraces including Mahmoudi, Azizi, Jneh Khotifa, Mekki, Biskri, Taganrog, Biada, Badri, Richi, Roussia and Souri were identified. Spike length (H' = 0.98), spike shape (H' = 0.86), grain size (H' = 0.94), grain shape (H' = 0.87) and grain color (H' = 0.86) were the most polymorphic morphological traits. The genetic diversity of these accessions was assessed using 10 simple sequence repeat (SSR) markers, with a polymorphic information content (PIC) of 0.69. Levels of genetic diversity were generally high (I = 0.62; He = 0.35). In addition, population structure analysis revealed 11 genetic groups, which were significantly correlated with the morphological characterization. Analysis of molecular variance (AMOVA) showed high genetic variation within regions (81%) and within genetic groups (41%), reflecting a considerable amount of admixture between landraces. The moderate (19%) and high (59%) levels of genetic variation detected among regions and among genetic groups, respectively, highlighted the selection practices of farmers. Furthermore, Mahmoudi accessions showed significant variation in spike density between central Tunisia (compact spikes) and southern Tunisia (loose spikes with open glume), may indicate an adaptation to high temperature in the south. Conclusion: Overall, this study demonstrates the genetic richness of local durum wheat germplasm for better in situ and ex situ conservation and for the subsequent use of these accessions in wheat breeding programs.
Degradome sequencing-based identification of phasiRNAs biogenesis pathways in Oryza sativa
Authors: Yu Lan , Guo Rongkai , Jiang Yeqin , Ye Xinghuo , Yang Zhihong , Meng Yijun , Shao Chaogang
Published: January 2021

Background: The microRNAs(miRNA)-derived secondary phased small interfering RNAs (phasiRNAs) participate in post-transcriptional gene silencing and play important roles in various bio-processes in plants. In rice, two miRNAs, miR2118 and miR2275, were mainly responsible for the triggering of 21-nt and 24-nt phasiRNAs biogenesis, respectively. However, compare to other plant species, relative fewer phasiRNA biogenesis pathways have been discovered in rice, which limits the comprehensive understanding of the mechanism of phasiRNA biogenesis and the miRNA derived regulatory network. Results: In this study, we performed a systematical searching for phasiRNA biogenesis pathways in rice. As a result, five novel 21-nt phasiRNA biogenesis pathways and five novel 24-nt phasiRNA biogenesis pathways were identified. Further exploration of the regulatory function of phasiRNAs revealed eleven novel phasiRNAs with 21-nt length targeting forty-one genes, most of which involving in the growth and development of rice. In addition, five novel phasiRNAs with 24-nt length were found targeting the promoter of an OsCKI1 gene and causing higher methylation status in panicle, implying their regulatory function of the transcription of OsCKI1, and subsequently affect the development of rice. Conclusions: These results substantially extended the information of phasiRNA biogenesis pathways and their regulatory function in rice.
Large air pressure changes triggered by P-SV ground motion in a cave in northern Taiwan
Authors: Chen Chieh-Hung , Sun Yang-Yi , Lin Li-Ching , Han Peng , Yu Huai-Zhong , Zhang XueMin , Tang Chi-Chia , Chen Chun-Rong , Yen Horng-Yuan , Lin Cheng-Horng , Liu Jann-Yenq , Lin Ching-Ren
Published: January 2021

A barometer in the cave of the SBCB station records an unusual phenomenon of larger amplitudes in air pressure changes inside than those at the Xinwu station (outside). Accordingly, the comparison between the recorded data at the SBCB and Xinwu station can drive investigations of potential sources of the unusual phenomenon. Analytical results of phase angle differences reveal that the air pressure outside the cave at the Xinwu station often leads air pressure changes inside at the SBCB station at relatively low frequency bands. In contrast, the larger pressure changes at frequencies > 2×10-4 Hz inside the cave at the SBCB station lead smaller changes outside at the Xinwu station. To expose causal mechanisms of the unusual phenomenon, continuous seismic waveforms recorded inside the cave at the SBCB station are further conducted for examination. When the horizontal and vertical ground velocities of ground motion yield a difference in the phase angle close to 90°, amplitudes of the air pressure changes at the SBCB station are amplified accordingly. This suggests that the pressure-shear vertical ground motion can drive air pressure changes. Meanwhile, the results shed light on investigating the existence of acoustic waves near the Earth’s surface using a partially confined space underground due to that the assumptions of the waves can propagate upward in the atmosphere driving changes in the ionosphere.
Exploring general practitioners’ perceptions about the primary care gatekeeper role in Indonesia
Authors: Mulyanto Joko , Wibowo Yudhi , Kringos Dionne S.
Published: January 2021

Background In the current healthcare delivery system funded by National Health Insurance (NHI) in Indonesia, the gatekeeper role of primary care services is critical to ensuring equal healthcare access for the population. To be effective, gatekeeping relies on the performance of general practitioners (GPs). However, the perceptions held by Indonesian GPs about their gatekeeper role are not yet well documented. This study describes the self-perceived knowledge, attitudes and performance of Indonesian GPs with respect to the gatekeeper role and explores associated factors. Methods We conducted a cross-sectional study of all primary care facilities (N = 75) contracted by the regional NHI office in the Banyumas district. The 73 participating GPs completed a written questionnaire that assessed their knowledge, attitudes and performance in relation to the gatekeeper role. Personal and facility characteristics were analysed in a generalised linear model as possible associating factors, as well as for the association between GPs’ knowledge and attitude with performance as gatekeepers. Results GPs scored relatively high in the domains of knowledge and performance but scored lower in their attitudes towards the gatekeeper role of primary care. In the full-adjusted model, no factors were significantly associated with the knowledge score. Work experience as GPs, private or civil service employment status and rural or urban location of the primary care facility were linked to attitude scores. Full- or part-time employment and type of facility were factors associated with the performance score. Attitude scores were positively associated with performance score.Conclusion GPs in Indonesia are knowledgeable and report that they adequately perform their function as gatekeepers in primary care. However, their attitudes towards the gatekeeper function are less positive. Attitudes and performance with respect to the primary care gatekeeper role are likely influenced more by contextual factors such as location and type of facility than by personal factors. Efforts to address contextual issues could include improvements in practice standards for privately practising physicians and public information campaigns about gatekeeping regulations. Such efforts will be crucial to improving the gatekeeper role of primary care in Indonesia and assuring efficient access to high-quality care for all.
Establishment of functional epithelial organoids from human lacrimal glands
Authors: Jeong Sang Yun , Choi Woo Hee , Jeon Seong Gyeong , Lee Sookon , Park Jong-Moon , Park Mira , Lee Hookeun , Lew Helen , Yoo Jongman
Published: January 2021

Background: Tear deficiency due to dysfunction of the lacrimal gland (LG) is one of the major causes of dry eye disease (DED). Therefore, LG stem cell-based therapies have been extensively reported to regenerate injured lacrimal tissue, but the number of stem cells in the LG tissue is pretty low, and 2D long-term cultivation results in the reduction of the differentiation capacity of stem cells. Whereas, 3D LG organoids could be an alternative for a DED therapeutic method, because it is capable of prolonged growth while maintaining the characteristics of the LG tissue. In this study, we developed LG organoids and applied them as cell therapeutics. Methods: Digested cells from human LG tissue were mixed with Matrigel and cultured in five different media modified from human prostate/salivary organoid culture media. After organoid formation, the growth, expression of specific markers and histological characters were analyzed to prove the LG organoids. And then, the secretory function of LG organoids was confirmed by calcium influx or proteomics after pilocarpine treatment. To explore the curability of developed organoids, finally, mouse-derived lacrimal gland organoids were fabricated and transplanted into mouse lacrimal tissue with DED. Results: The histological features and specific marker expression of LG organoids were similar to normal LG tissue. In the pilocarpine treated LG organoid, internal Ca2+ ions and β -hexosaminidase as known a lysosomal protein in tear fluid was increased. Also, the secreted proteins from pilocarpine treated lacrimal organoid were identified through proteomics. More than 70% of the identified proteins were proven to exosome through GO analysis. These results indicate that our developed organoid has a reactivity to pilocarpine, which shows the function of the lacrimal gland. Additionally, we developed LG organoids from Sjogren’s syndrome patients (SS) and confirmed that their histological feutures similar to that of SS-derived LG tissue. Finally, we confirmed that organoids were well engrafted in the lacrimal tissue at 2 weeks after transplantation of mouse LG orgnoid. Conclusion: This current study demonstrate that our established lacrimal gland organoids resemble characteristics of normal lacrimal gland tissue and could be used as cell therapy for patients with dry eye syndrome.
Linkage analysis, GWAS, transcriptome analysis to identify candidate genes for rice seedlings in response to high temperature stress
Authors: Wei Zhaoran , Yuan Qiaoling , Lin Hai , Li Xiaoxia , Zhang Chao , Gao Hongsheng , Zhang Bin , He Huiying , Liu Tianjiao , Zhang Jie , Gao Xu , Shi Shandang , Wang Bo , Gao Zhenyu , Kong Lingrang , Qian Qian , Shang Lianguang
Published: January 2021

Background: Rice plants suffer from the rising temperature which is becoming more and more prominent. Mining heat-resistant genes and applying them to rice breeding is a feasible and effective way to solve the problem.Result: Three main biomass traits, including shoot length, dry weight, and fresh weight, changed after abnormally high temperature treatment in the rice seedling stage of a recombinant inbred lines and germplasm population. Based on a comparison of the results of linkage analysis and genome-wide association analysis, two loci with lengths of 57 kb and 69 kb in qDW7 and qFW6, respectively, was associated with the rice response to abnormally high temperatures in the seedling stage. Meanwhile, based on integrated transcriptome analysis, some genes are considered as important candidate genes. Combining with known genes and analysis of homologous genes, it was found that there are eight genes in candidate intervals that need to be focused in subsequent research.Conclusions: The results indicated several relevant loci, which would help researchers to further discover beneficial heat-resistant genes that can be applied to rice heat-resistant breeding.
A semi-dominant mutation in OsCESA9 improves salt tolerance and favors field straw decay traits by altering cell wall properties in rice
Authors: Ye Yafeng , Wang Shuoxun , Wu Kun , Ren Yan , Jiang Hongrui , Chen Jianfeng , Tao Liangzhi , Fu Xiangdong , Liu Binmei , Wu Yuejin
Published: January 2021

Background: Cellulose synthase (CESA) mutants have potential use in straw processing due to their lower cellulose content, but almost all of the mutants exhibit defective phenotypes in plant growth and development. Balancing normal plant growth with reduced cellulose content remains a challenge, as cellulose content and normal plant growth are typically negatively correlated with one another. Result: Here, the rice (Oryza sativa) semi-dominant brittle culm (sdbc) mutant Sdbc1, which harbors a substitution (D387N) at the first conserved aspartic acid residue of OsCESA9, exhibits lower cellulose content and reduced secondary wall thickness as well as enhanced biomass enzymatic saccharification compared with the wild type (WT). Further experiments indicated that the OsCESA9D387N mutation may compete with the wild-type OsCESA9 for interacting with OsCESA4 and OsCESA7, further forming non-functional or partially functional CSCs. The OsCESA9/OsCESA9D387N heterozygous plants increase salt tolerance through scavenging and detoxification of ROS and indirectly affecting related gene expression. They also improve rice straw return to the field due to their brittle culms and lower cellulose content without any negative effects in grain yield and lodging. Conclusion: Hence, OsCESA9D387N allele can improve rice salt tolerance and provide the prospect of the rice straw for biofuels and bioproducts due to its improved enzymatic saccharification.
Perspectives of family physicians towards access to lung cancer screening for individuals living with low income - a qualitative study
Authors: Sayani Ambreen , Vahabi Mandana , O’Brien Mary Ann , Liu Geoffrey , Hwang Stephen W. , Selby Peter , Nicholson Erika , Lofters Aisha
Published: January 2021

Background: Individuals living with low income are less likely to participate in lung cancer screening (LCS) with low-dose computed tomography. Family physicians (FPs) are typically responsible for referring eligible patients to LCS; therefore, we sought to understand their perspectives on access to lung cancer screening for individuals living with low income in order to improve equity in access to LCS. Methods: A theory-informed thematic analysis was conducted using data collected from 11 semi-structured interviews with FPs recruited from three primary care sites in downtown Toronto. Data was coded using the Systems Model of Clinical Preventative Care as a framework and interpretation was guided by the synergies of oppression analytical lens. Results: Four overarching themes describe FP perspectives on access to LCS for individuals living with low income: the degree of social disadvantage that influences lung cancer risk and opportunities to access care; the clinical encounter, where there is often a mismatch between the complex health needs of low income individuals and structure of health care appointments; the need for equity-oriented health care, illustrated by the neglect of structural origins of health risk and the benefits of a trauma-informed approach; and finally, the multiprong strategies that will be needed in order to improve equity in health outcomes. Conclusion: An equity-oriented and interdisciplinary team based approach to care will be needed in order to improve access to LCS, and attention must be given to the upstream determinants of lung cancer in order to reduce lung cancer risk.
GESTÃO DE MEDICAMENTOS: ESTUDO DE CASO EM UMA UNIDADE DE SAÚDE DE MACEIÓ/AL
Authors: Levino Natallya , Brito Bruna Luana
Published: January 2021

A economia em saúde vem, ao longo dos anos, ganhando relevância em virtude dos altos gastos da saúde pública e privada.  Paralelamente a isso, vive-se o contraponto entre o aumento dos custos e gastos relacionados à assistência médico-hospitalar. Mas, como ofertar um serviço público assistencial de qualidade, com recursos escassos, reduzindo/mantendo custos, maximizando/mantendo resultados, sem, contudo, desconsiderar a busca pela eficiência e o anseio à modernização de suas estruturas física, humana e administrativa? O objetivo deste trabalho é analisar o processo de gestão de custos e estoques de medicamentos de uma unidade de saúde de Maceió/AL, tendo como unidade de estudo a Farmácia Hospitalar. Foi realizada uma pesquisa aplicada, descritiva, com abordagem qualitativa, cujo procedimento técnico foi o estudo de caso, durante os meses de Julho a Novembro de 2018. Constatou-se que as principais dificuldades referem-se à falta de integração entre os departamentos, as limitações de software de gerenciamento de estoques e custos, e principalmente, dificuldades de cunho financeiro, que impedem o relacionamento colaborativo com fornecedores e é calcado por restrições orçamentárias que prejudicam a prestação de serviços.
A PANDEMIA DE COVID-19 SOB A BENÇÃO DE BOLSONARO E EVANGÉLICOS
Authors: Silva Emanuel Freitas da , Sena da Silveira Emerson
Published: January 2021

A pandemia de Covid-19 mostra, contundentemente, a convergência entre interesses ideológicos de amplos setores evangélicos e a coalização neoliberal encabeçada pelo governo Bolsonaro. Quais os fundamentos dessa afinidade, nos perguntamos. Num contexto de mobilização política anti-ciência, nossa hipótese é a de que a crítica à razão científica, marcada pela hegemonia do pensamento mágico (ligação direta entre desejo e realidade) e a situação de pós-verdade (negação dos critérios de verificação da verdade e da falsidade de enunciados) permitiram essa afinidade. Baseados em métodos qualitativos de análise sociológica e nas reflexões de clássicos (Weber, Durkheim, Marx, Manheim, Foucault), analisamos posicionamentos e postagens de duas deputadas estaduais evangélicas nordestinas bolsonaristas em redes sociais.