bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic Syndrome Among Children and Adolescents in Low and Middle Income Countries: A Systematic Review and Meta-analysis
Authors: Bitew Zebenay Workneh , Alemu Ayinalem , Ayele Ermias Getaneh , Tenaw Zelalem , Alebel Anmut , Worku Teshager
Published: September 2020

Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is raising the low and middle income countries (LMICs). There are various studies with inconsistent findings, but they are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among the overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.
Intestinal Absorption Mechanisms of Five Flavonoids from Malus hupehensis (Pamp.) Rehd. Extracts in Situ Single-Pass Intestinal Perfusion and in Vitro Caco-2 Cell Model
Authors: Yang Hui , Tang Zhishu , Cheng Jiangxue , Wang Jing , Zou Junbo , Zhang Xiaofei , Shi Yajun , Guo Dongyan
Published: September 2020

Background: Previous studies have shown that Malus hupehensis (Pamp.) Rehd. extracts have anti-oxidant, anti-aging and other effects, its bioavailability is low, however its absorption mechanism is still unclear. To investigate the absorption properties of hyperin, quercitrin, phloridzin, quercetin, and phloretin in total flavonoids of Malus hupehensis (Pamp.) Rehd. Extracts. Methods: In situ single-pass intestinal perfusion model and in vitro Caco-2 cell model were used in this study. The effects of concentration of the extract, administration time, temperature, different intestinal segments, paracellular pathway were analyzed, and the effect of efflux inhibitors, such as the P-gp inhibitor verapamil, the multidrug resistance protein2 (MRP2) inhibitor indomethacin, the breast cancer resistance protein (BCRP) inhibitor reserpine, on the transport were evaluated. As well as EDTA, a tight junction regulator, was studied.Results: The results indicated that the jejunum was the optimal absorption intestine segment of quercitrin, phloridzin, and phloretin. And the greatest absorption intestine segment of quercetin was ileum. Furthermore, it was found that the absorption mechanisms of phloridzin in extract was involved in passive diffusion and the mediation of P-gp and MRP2 should not be neglected. The absorption mechanisms of quercetin and phloretin from extract involved active transport and were accompanied by the participation of efflux transporters, such as P-gp, MRP2 and BCRP. And also the paracellular pathway was involved in hyperin and quercitrin. Conclusion: The absorption mechanisms of five flavonoids from Malus hupehensis (Pamp.) Rehd. extract are related to the concentration of the drugs, intestinal segments, and efflux protein.
Preoperative Plasma Fibrinogen: An Independent Predictor for Survival in Adult Patients with Xp11.2 Translocation Renal Cell Carcinoma
Authors: Dong Jie , Xu Weifeng , Ji Zhigang , Pan Boju
Published: September 2020

Background. Xp11.2 translocation renal cell carcinoma, a rare malignancy, is more common in children than in adults. It manifests with an aggressive course in adults and relatively indolent in children. Prognostic studies for adult patients are scare for the rarity of the disease; and the prognostic value of preoperative plasma fibrinogen awaits further illumination.Methods. This retrospective single-center study enrolled 24 consecutive newly diagnosed Xp11.2 translocation RCC adult patients. Clinical presentations, baseline laboratory results and follow-up data were collected. Possible risk factors for progression free survival and overall survival were first scanned with chi-square tests and t-tests to compare patients who suffered from progression or death and who did not. Multivariate Cox regression was further utilized to identify independent risk factors.Results. Twenty-four adult patients (median age 32, range 16-73), with a male-to-female ratio of 1:1, was included from 2010.4 to 2020.3. After a mean follow-up of 35.7months, seven patients died. With univariate analysis, higher C-reactive protein-to-albumin ratio (p=0.028), higher baseline fibrinogen (p=0.006), and presence of distant metastasis (p=0.007) were associated with progression of disease; higher preoperative fibrinogen (p=0.014) and distant metastasis (p=0.020) were associated with death. With multivariate Cox regression, only baseline fibrinogen level (p=0.001) was identified as an independent risk factor for progression free survival; meanwhile, fibrinogen level (p=0.048) and distant metastasis (p=0.043) were identified as independent risk factors for survival.Conclusions. Preoperative plasma fibrinogen, a routinely tested parameter before surgery, is a promising tool for risk stratification in adult patients with Xp11.2 translocation renal cell carcinoma.JIE et al: Preoperative plasma fibrinogen predicts outcome in Xp11.2 translocation RCC
The Prognostic Value of the SOFA Score in Patients with COVID-19: A Retrospective, Observational Study
Authors: Yang Zheng , Hu Qinming , Huang Fei , Xiong Shouxin , Sun Yi
Published: September 2020

Background: Patients with Coronavirus disease 2019 (COVID-19) have a high mortality rate, and thus, it is particularly important to predict the severity and prognosis of COVID-19. The Sequential Organ Failure Assessment (SOFA) score has been used to predict the clinical outcomes of patients with multiple organ failure requiring intensive care. Therefore, we retrospectively analyzed the clinical characteristics, risk factors, and relationship between the SOFA score and the prognosis of COVID-19 patients.Methods: Clinical variables were compared between patients with mild and severe COVID-19. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for severe COVID-19. The Cox proportional hazards model was used to analyze risk factors for hospital-related death. Survival analysis was performed by the Kaplan-Meier method, and survival differences were assessed by the log-rank test. Receiver operating characteristic (ROC) curves of the SOFA score in different situations were drawn, and the area under the ROC curve was calculated.Results: The median SOFA score of all patients was 2 (IQR, 1-3). Patients with severe COVID-19 exhibited a significantly higher SOFA score than patients with mild COVID-19 [3 (IQR, 2-4) vs 1 (IQR, 0-1); P<0.001]. The SOFA score increased the risk of severe COVID-19, with an odds ratio of 5.851 (95% CI: 3.044-11.245; P<0.001). The area under the ROC curve (AUC) was used to evaluate the diagnostic accuracy of the SOFA score in predicting severe COVID-19 [cutoff value = 2; AUC = 0.908 (95% CI: 0.857-0.960); sensitivity: 85.20%; specificity: 80.40%] and the risk of death in COVID-19 patients [cutoff value = 5; AUC = 0.995 (95% CI: 0.985-1.000); sensitivity: 100.00%; specificity: 95.40%]. Regarding the 60-day mortality rates of patients in the two groups classified by the optimal cutoff value of the SOFA score (5), patients in the high SOFA score group (SOFA score ≥5) had a significantly greater risk of death than those in the low SOFA score group (SOFA score <5).Conclusion: The SOFA score could be used to evaluate the severity and 60-day mortality of COVID-19. The SOFA score may be an independent risk factor for in-hospital death.
Acceptability and Appropriateness of a Novel Parent-Staff Co-Leadership Model for Childhood Obesity Prevention in Head Start: A Qualitative Interview Study
Authors: Beckerman-Hsu Jacob Philip , Gago Cristina , Aftosmes-Tobio Alyssa , Jurkowski Janine M , Lansburg Kindra , Leonard Jessie , Torrico Merieka , Haneuse Sebastien , Subramanian SV , Kenney Erika L , Davison Kirsten K
Published: September 2020

Background: Peer leadership can be an effective strategy for implementing health programs, benefiting both program participants and peer leaders. To realize such benefits, the peer leader role must be appropriate for the community context. Also, peer leaders must find their role acceptable (i.e., satisfactory) to ensure their successful recruitment and retention. To date, parent peer leaders have seldom been part of early childhood obesity prevention efforts. Moreover, parents at Head Start preschools have rarely been engaged as peer leaders. The aim of this study is to evaluate the appropriateness and acceptability of an innovative model for engaging parents as peer leaders for this novel content area (early childhood obesity prevention) and setting (Head Start).Methods: Parents Connect for Healthy Living (PConnect) is a 10-session parent program being implemented in Head Start preschools as part of the Communities for Healthy Living early childhood obesity prevention trial. PConnect is co-led by a parent peer facilitator who is paired with a Head Start staff facilitator. In the spring of 2019, 10 PConnect facilitators participated in a semi-structured interview about their experience. Interview transcripts were analyzed by two coders using an inductive-deductive hybrid analysis. Themes were identified and member-checked with two interviewees.Results: Acceptability was high because PConnect facilitators were able to learn and teach, establish meaningful relationships, and positively impact the parents participating in their groups, although facilitators did express frustration when low attendance limited their reach. Appropriateness was also high, as PConnect provided adequate structure and support without being overly rigid, and facilitators were able to overcome most challenges they encountered.Conclusions: The PConnect co-facilitation model was highly acceptable and appropriate for both the parent facilitators (peer leaders) and the staff facilitators. Including parents as peer leaders aligns to Head Start’s emphasis on parent engagement, making it a strong candidate for sustained implementation in Head Start. The insights gained about the drivers of peer leadership appropriateness and acceptability in this particular context may be used to inform the design and implementation of peer-led health programs elsewhere.
Evaluation of carbapenem-resistant Enterobacteriaceae (CRE) Guideline Implementation in the Veteran’s Affairs Medical Centers Using the Consolidated Framework for Implementation Research
Authors: Goedken Cassie Cunningham , Guihan Marylou , Brown Charnetta R. , Ramanathan Swetha , Vivo Amanda , Suda Katie J. , Fitzpatrick Margaret A. , Poggensee Linda , Perencevich Eli N. , Rubin Michael , Reisinger Heather Schacht , Evans Martin , Evans Charlesnika T.
Published: September 2020

Background: Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) and carbapenemase-producing (CP) CRE are difficult to treat, resulting in high mortality in healthcare settings every year. The Veteran’s Health Administration (VHA) disseminated guidelines in 2015 and an updated directive in 2017 for control of CRE focused on laboratory testing, prevention, and management. The Consolidated Framework for Implementation Research (CFIR) framework was used to examine contextual factors and identify best practices influencing implementation of the 2015 guidelines/2017 directive in VA Medical Centers (VAMCs).Methods: Qualitative interviews were conducted at 29 VAMCs with staff involved in implementing CRE guidelines at their facility. Survey and VHA administrative data were used to identify geographically representative large and small VAMCs with varying levels of CRE incidence. Interviews addressed perceptions of guideline dissemination, laboratory testing, staff attitudes and training, patient education, and technology support. Participant responses were coded using a consensus-based mixed deductive-inductive approach guided by CFIR. A quantitative analysis comparing CFIR constructs and emergent codes to sites actively screening for CRE (vs. non-screening) and any (vs. no) CRE positive cultures was conducted with a Fisher’s exact test.Results: Forty-three semi-structured interviews were conducted between 10/2017-8/2018 with laboratory staff (47%), Multi-Drug Resistant Organism Program Coordinators (MPCs, 35%), infection preventionists (12%), and physicians (6%). Participants cited the need for more standardized tools to promote effective communication (e.g., electronic screening). Participants also indicated that CRE-specific educational materials were needed for staff, patient, and family members. Quantitative analysis identified the following CFIR constructs as being significantly associated with CRE screening or presence of CRE: Leadership Engagement, Relative Priority Available Resources, Team Communication, and Access to Knowledge & Information. Conclusions: Effective CRE identification, prevention and treatment requires ongoing collaboration between clinical, microbiology, infection prevention, antimicrobial stewardship, and infectious diseases specialists. Our results emphasize the importance of leadership’s role in promoting positive facility culture, including increasing healthcare worker’s awareness of infection control and prevention for emerging pathogens, access to resources, improving communication and facilitating successful implementation of the CRE guidelines.
Aptamer-Functionalized Dendrimer Delivery lncRNA MEG3 Enhances Castration-Resistant Prostate Cancer Gene Therapy
Authors: Tai Zongguang , Ma Jinyuan , Ding Jianing , Pan Huijun , Chai Rongrong , Zhu Congcong , Cui Zhen , Chen Zhongjian , Zhu Quangang
Published: September 2020

Androgen castration therapy is an effective treatment method for prostate cancer patients who cannot be completely cured by surgery. However, drug resistance often leads to treatment failure and poor prognosis. For castration-resistant prostate cancer (CRPC), some new treatment methods have been gradually put into clinical validation or use. Considering the side effects of traditional treatment, gene therapy has been applied in recent studies to combat prostate cancer (PCa). A 19-nt RNA aptamer, termed as EpDT3, is endocytosed when bound to epithelial cell adhesion molecule EpCAM-overexpressing cells, including various types of prostate cancer cells. Therefore, poly (amidoamine) dendrimer (PAMAM) conjugated with EpDT3 on the surface was developed for gene delivery targeting the CRPC. Moreover, the PAMAM-PEG-EpDT3 vehicles were accumulated in CRPC cells. The CRPC-inhibitory effect of PAMAM modified with EpDT3 was significantly higher than that of the unmodified construct when loading the plasmid that encodes long noncoding (lnc) RNA MEG3 (pMEG3). In summary, the above results suggested that PAMAM-PEG-EpDT3/pMEG3 nanoparticles (NPs) have great potential for enhancing CRPC gene therapy.
Comparison of Characteristics and Outcome in Asymptomatic COVID-19 Patients Before and After Hospitalization in Korea
Authors: Hyun Miri , Lee Ji Yeon , Park Jae Suck , Kim Hyun Ah
Published: September 2020

Background: The progression of coronavirus disease-2019 (COVID-19) is less well-studied in asymptomatic patients. The study aimed to understand the clinical characteristics of asymptomatic COVID-19 patients at the time of admission and follow-up their occurrence of symptoms during hospitalization.Methods: Patients were divided into two groups—those with no symptoms until discharge (group A) and those who had symptoms that developed during hospitalization (group B). Baseline and clinical characteristics were retrospectively measured, and logistic regression analysis was performed to identify risk factors for deterioration during hospital stay.Results: Overall, 223 patients were enrolled in the study, including 42 and 181 patients in groups A and B, respectively. Patients were older in group B than in group A. They developed cough as the most common symptom. Abnormal initial chest X-ray (CXR) and higher levels of C-reactive protein were frequently observed in group B than in group A. Moreover, 5 patients required mechanical support, including hi-flow nasal cannular and mechanical ventilation in group B. Five patients were transferred to tertiary hospitals owing to deterioration, and 4 patients succumbed to COVID-19. The risk factors for deterioration were age over 75 years, diabetes mellitus, and C-reactive protein > 1.Conclusions: Even when the patients have no symptoms at admission, we recommend close monitoring of symptoms during hospital stay in patients who present with risk factors at the time of admission.
Clinical characteristics study of elderly patients aged 75 or older with COVID-19 pneumonia in China
Authors: Zhang Chao , Fu Hua , Zhang Long , Yin Yuxiong , Lin Jing , Liu Hu , Mao Qing
Published: September 2020

Background: Coronavirus disease 2019 (COVID-19), a newly emerged respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently become pandemic. Clinical observation indicated that elderly patients had high incidence of severe pneumonia and poor treatment efficacy. Therefore, this study was to clarify the characteristics of elderly patients aged 75 or older with COVID-19 pneumonia in order to guide rational treatment for elderly patients. Methods: we enrolled 331 elderly patients aged 75 or older with confirmed COVID-19 in Huoshenshan hospital of Wuhan from February 3rd to March 31st. The cases were divided into general, serious and critical groups according to severity after hospitalization, and the difference among groups were compared by R package statistics software. Results: Compared with general group, serious and critical groups had more underlying comorbidities and higher incidence of cough, breath shortness and anorexia. Moreover, there existed obviously differences in many of laboratory indexes and CT images among them. serious and critical elderly patients were more likely to receive oxygen, mechanical ventilation, expectorant, corticosteroid, abidor, cephaloprin, imipenem, human serum albumin (HSA), nutrition support, anti SARS-CoV-2 positive plasma and actemra. Multivariate analysis of factors showed that male sex, hypertension, diabetes, renal diseases, breath shortness, neutrophil, platelet, creatinine, lactate dehydrogenase were the risk factor for serious and critical illness. While blood cell (WBC) was the protective factor. Conclusion: elderly patients have high incidence of severe pneumonia and poor treatment efficacy. The reasons might be that many of the elderly patients with COVID-19 pneumonia have certain chronic disease, poor immune function and a meager response to the virus. the pathogenic mechanism of SARS-CoV-2 might be involved in the cell-mediated immunity and cytokine storms by acting on lymphocytes.
C-Reactive Protein and Lymphocyte are important indicators of severe coronavirus disease and poor prognosis in elderly patients
Authors: He Qinglin , Hu Xiafen , Xiang Xiaochen , Chen Siyang , Liu Wanxin , Liu Xiaoliu , Wang Qiang , Guo Kaiwen , Wu Qingming
Published: September 2020

Objective：To explore the value of C-reactive protein (CRP) and lymphocyte (L) in the assessment of disease severity and prognosis of elderly COVID-19 patients.Methods: A total of 194 positive COVID-19 patients were collected from Tianyou Hospital and Puren Hospital, affiliated hospital of Wuhan University of Science and Technology. Their demographic characteristics were analyzed. The dynamic changes of CRP and L in peripheral blood were retrospectively studied.Results: (1) There were significant statistical differences in CRP, L in clinical typing and clinical outcome in patients over 60 years old compared with those under 60 years old. Survival analysis showed that the risk of death was greater in patients over 60 than in those under 60.（2）In 125 patients over 60 years old, the hospitalized patients with severe or critical types of disease had significantly higher CRP than those with moderate type (p<0.01). In the outcome of the elderly patients, the CRP of the patients with the outcomes of discharge, improvement, aggravation and death increased successively (p<0.01). According to the analysis of Logistic regression model, the increase of CRP constitutes a risk factor for death in elderly patients. (3) In the ROC curve analysis to distinguish the death outcome and non-death outcome of COVID-19 patients, the area under the curve (AUC) of CRP and L was 0.751 and 0.720 respectively. CRP and L had good diagnostic accuracy for the death outcome of patients. (4) Changes in CRP were correlated with changes in CT imaging and were consistent with changes in the course of the disease.Conclusions: (1) The cumulative survival rate of patients over 60 years old was lower than that of patients under 60 years old. With the increase of age, the CRP of patients showed an increasing trend, and the L of patients showed a characteristic lower than the normal reference interval. (2) CRP and L are important monitoring indicators of COVID-19 in elderly patients. Combined with CT examination and observation of their dynamic changes, CRP and L are of important clinical guiding value for the judgment of disease severity and the evaluation of prognosis.
Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations
Authors: Lee Hyun Jung , Shin Dong Hoon , Park Joon Young , Kim So Young , Hwang Chung Su , Lee Jung Hee , Kim Jee Yeon , Sol Mee Young , Nam Jong Kil
Published: September 2020

BackgroundThe presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report multiple synchronous masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity in the same kidney. Herein, we present the first well-explained case with immunohistochemical findings with next-generation sequencing (NGS) analysis. Case presentationA 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for one week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses in the upper to mid pole measuring 5.6 × 4.0 × 3.3 cm and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G>T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with an additional PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G>A/p.E542K in exon 10).ConclusionsWe report here an extraordinarily rare case of a patient diagnosed with multiple synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.
Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation
Authors: Singh Neha , Saini Megha , Kumar Nand , Srivast M.V. Padma , Mehndiratta Amit
Published: September 2020

Background: A novel electromechanical robotic-exoskeleton was designed in-house for rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. Objective: The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training-sessions with dose-matched control in patients with stroke. Methods: An observational pilot study was designed with patients within 2 years of chronicity. Patients received an intervention of 20 sessions of 45-minutes each, five days a week for four-weeks) in Robotic-therapy Group (RG) (n=12) and conventional upper-limb rehabilitation in Control-Group (CG) (n=11). Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunstrom-stage and Fugl-Meyer scale (Shoulder/Elbow and Wrist/Hand component), and neurophysiological-measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor-threshold, were acquired pre and post-therapy. Results: RG and CG showed significant improvement in all clinical motor-outcomes (p<0.05) except Modified Ashworth Scale in CG. RG showed significantly higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer (FM) scale and FM Wrist-/Hand component) (p<0.05). Increase in cortical-excitability in ipsilesional-hemisphere was found to be statistically significant in RG over CG, as indexed by decrease in Resting Motor-Threshold and increase in amplitude of Motor Evoked Potential (p<0.05). No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant changes in RG over CG (p<0.05) indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes.Conclusion: Neurophysiological-changes in RG could be most likely a consequence of plastic-reorganization and use-dependent plasticity. Robotic-exoskeleton training could significantly improve motor-outcomes and cortical-excitability in patients with stroke.Registry number: IEC/NP-99/13.03.2015
Conditioned Medium of Bone Marrow Mesenchymal Stem Cells Relieves Acute Lung Injury in Mice by Regulating Epithelial Sodium Channels via miR-34c
Authors: Zhou Zhiyu , Cui Yong , Hou Yapeng , Yu Tong , Ding Yan , Nie Hongguang
Published: September 2020

Aims: One of the characteristics of acute lung injury (ALI) is severe pulmonary edema, which is closelyrelated to alveolar fluid clearance. Mesenchymal stem cells (MSCs) secrete a wide range of cytokines,growth factors and miRNAs through paracrine action to participate in the mechanism of pulmonaryinflammatory response, which increases the clearance of edema fluid, and promotes the repair process ofALI. However, the mechanism by which bone marrow derived MSCs-conditioned medium (BMSCs-CM)promotes edema clearance is unclear. Epithelial sodium channel (ENaC) is the rate-limiting step in thesodium-water transport and edema clearance in the alveolar cavity, and we aim to explore the role of ENaCin BMSCs-CM invloved edema clearance and whether it can alter the function of ENaC via miRNAs.Methods: CCK-8 cell proliferation assay was used to detect the effect of BMSCs-CM on the survival ofAT2 cells. Real-time PCR (RT-PCR) and Western blot were used to detect the expression of ENaC in AT2cells. The effects of exosomes/miR-34c on the transepithelial short-circuit current in the monolayer of H441cells were examined by the Ussing chamber setup. Dual luciferase reporter gene assay was used to detect thetarget gene of miR-34c.Results: BMSCs-CM can increase the viability of mouse AT2 cells. RT-PCR and Western blotting resultsshowed that BMSCs-CM significantly increased the expression of γ-ENaC subunit in mouse AT2 cells.Ussing chamber assay revealed that BMSCs-CM enhanced the amiloride-sensitive currents associated withENaC activity in intact H441 cell monolayers. In addition, we observed higher expression of miR-34c inmouse AT2 cells administrated with BMSCs-CM, and the overexpression or inhibition of miR-34c canregulate the expression of ENaC protein and alter the function of ENaC. Finally, we detected MARCKS maybe one of the target gene of miR-34c.Conclusions: Our results indicate that BMSCs-CM may improve LPS-induced ALI through miR-34ctargeting MARCKS and regulating ENaC indirectly, which further explores the benefit of paracrine effectsof BMSCs on edematous ALI.
Clinical Risk Factors Associated with Radiographic Osteoarthritis Progression Among People with Knee Pain: A Longitudinal Study
Authors: Simic Milena , Harmer Alison R. , Agaliotis Maria , Nairn Lillias , Bridgett Lisa , March Lyn , Votrubec Milana , Edmonds John , Woodward Mark , Day Richard , Fransen Marlene
Published: September 2020

Background:The aim of this study was to identify modifiable clinical factors associated with radiographic osteoarthritis progression over one-to-two years in people with painful medial knee osteoarthritis.Methods:A longitudinal study was conducted within a randomised controlled trial, the “Long-term Evaluation of Glucosamine Sulfate” (LEGS study). Recruitment occurred 2007-2009, with one and two-year follow-up assessments by blinded assessors. Community-dwelling people with chronic knee pain (≥4/10) and medial tibiofemoral narrowing (but retaining >2mm medial joint space width) on radiographs were recruited. From 605 participants, follow-up data were available for 498 (82%, mean[sd] age: 60[8] years). Risk factors evaluated at baseline were pain, physical function, use of non-steroidal anti-inflammatory drugs (NSAIDs), statin use, not meeting physical activity guidelines, presence of Heberden’s nodes, history of knee surgery/trauma, and manual occupation. Multivariable logistic regression analysis was conducted adjusting for age, sex, obesity, high blood pressure, allocation to glucosamine and chondroitin treatment, and baseline structural disease severity (Kellgren and Lawrence grade, joint space width and varus alignment). Radiographic osteoarthritis progression was defined as joint space narrowing ≥0.5mm over one-to-two years (latest follow-up used where available).Results:Radiographic osteoarthritis progression occurred in 58 participants (12%). Clinical factors independently associated with radiographic progression were: use of NSAIDs, adjusted odds ratios (OR) and 95% confidence intervals (CI) 2.05 (95%CI:1.1 to 3.8), and not meeting physical activity guidelines, OR 2.07 (95%CI:0.9 to 4.7).Conclusions: Among people with mild radiographic knee osteoarthritis, people who use NSAIDs and/or do not meet physical activity guidelines have greater risk of radiographic osteoarthritis progression.Trial Registration: This original study trial was registered apriori. ClinicalTrials.gov identifier: NCT00513422; http://www.clinicaltrials.gov. Current study hypothesis arose before inspection of the data.
Spatiotemporal Variability of Longshore Sediment Transport on the Brazilian Coast
Authors: Trombetta Thaisa Beloti , Marques Wiliam Correa
Published: September 2020

The lack of planning and management regarding the transport of sediments along the coast can alter the existing equilibrium in coastal regions, causing or accelerating erosive processes and resulting in economic and environmental damage. Thus, it is important that the characteristics of the coastal drift be investigated, serving as source of information for future projects involving the coastal environment management. Within this context, the present work aims to identify the annual sediment transport averages along the Brazilian coast, the dominant direction of the coastal drift and its spatial variability. For this, a wind-generated wave modeling was considered, with 37 years of data (1979 to 2015), as well as four sediment transport formulations. For the spatiotemporal variability, the analysis of wavelets was applied, relating the effect of cycles of variability over the behavior of longshore sediment transport. The results showed that the largest annual volumes of sediment transport occurred in the northeastern Region of Brazil, reaching approximately 850000 m3/year-1. On the other hand, the smallest transport averages occurred in the southern region, in the state of Santa Catarina, reaching the value of 13497 m3/year-1. In the northeast region, annual and interannual cycles were more frequent and more energetic than in the southern Region, where short cycles presented similar importance to longer cycles, during 37 years of the study. However, in the overall context of the analysis, the long period cycles are more significant for longshore sediment transport, since this is a long term process. In this way, the present article contributes with information on longshore sediment transport, highlighting the annual means and the dominant drift, and deals with important questions about the influence of cycles of variability in the study region, emphasizing the importance of longer period events for the control of sedimentary transport in the Brazilian coast.
Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach
Authors: Vermandere Heleen , Aguilera-Mijares Santiago , Martínez-Vargas Liliane , Colchero M. Arantxa , Bautista-Arredondo Sergio
Published: September 2020

Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.
The Nexus Between Health Status and Health Expenditure, Energy Consumption and Environmental Pollution: Empirical Evidence from SAARC-BIMSTEC Regions
Authors: Rahman Mohammad Mafizur , Alam Khosrul
Published: September 2020

Background: The prevailing COVID-19 pandemic made us deep concern for considering the betterment of health status along with health expenditure, energy, and environmental issues all over the world. This paper examines the nexus between health status and health expenditures (both public and private), energy consumption and environmental pollution in the SAARC-BIMSTEC region.Methodology: We have utilized the panel autoregressive distributed lag (ARDL) model, heterogeneous panel causality test, cross sectional dependence test, cointegration test and Pesaran cross sectional dependent (CADF) unit root test for obtaining estimated results from the data of 16 years (2002-2017). Results: The acquired results authorize the cointegration among the variables used, where energy consumption, public and private health expenditure and economic growth have positive and statistically significant effects and environmental pollution has both negative and significant effects on the health status of these regions in the long-run, but no panel wise significant impact is found in the short-run. Two-way causal relationships between health status and environmental pollution, public and private health expenditure, economic growth and sanitation facilities, and a one-way causality running from energy consumption to health status are revealed.Conclusions: The improved health status in the SAARC-BIMSTEC region required to be protected by articulating the effective policies on both public and private health expenditures, environmental pollution, energy consumption, and economic growth. The attained results are theoretically and empirically consistent, and have important policy implications in the health sector.JEL codes: I10, I15, I18, C23
The Compatibility of Alisma and Atractylodes Affects the Biological Behaviors of VSMCs Via Inhibiting miR-128-5p / p21 Gene
Authors: Wei Wei , Shen Ju Lian , Lu Lu , Lv Xin Ru , Lu Tao Tao , Xue XieHua
Published: September 2020

Background：The compatibility of Alisma and Atractylodes (AA) has been estimated to exhibit anti-athero­sclerotic effects, while the mechanism still remains unclear. This study was aimed to identify the role of AA on oxidized low density lipoprotein (ox-LDL)-induced vascular smooth muscle cells (VSMCs) behaviors, and to explore the effect of microRNAs (miRNAs). Methods：Scratch wound healing assay detected the migration of VSMCs, immunocytochemistry assay and western blot of SM22ɑ were used to evaluated the phenotypic transformation. Bromodeoxyuridine (Brdu) immunocytochemistry and flow cytometry were applied to detect the proliferation of VSMCs. The miRNA microarray profiling was performed using lianchuan biological small RNA sequencing analysis. VSMCs were transfected with the miR-128-5p mimic and inhibitor, the migration, phenotypic modulation and proliferation of VSMCs were investigated. The 3'UTR binding sequences site of miR-128-5p on p21 gene were predicted and assessed by luciferase assays.Results：AA and extracellular regulated protein kinases 1/2 (ERK1/2) blocker U0126 markedly inhibited the ability of migration, elevated smooth muscle 22alpha (SM22α) expression, repressed VSMCs proliferation, elevated the expression of miR-466f-3p and miR-425-3p, while suppressed miR-27a-5p and miR-128-5p expression in the ox-LDL-induced VSMCs. MiR-128-5p targets tissue inhibitor of metalloproteinase (TIMPs), silent information regulator 2 (SIRT2), peroxisome proliferator-activated receptors (PPARs) and p21 genes, which is linked to the behaviors of VSMCs. MiR-128-5p mimic promoted migration and proliferation of VSMCs, and suppressed the p21, p27 and SM22ɑ expression. The inhibitor increased p21, p27 and SM22ɑ expression, and repressed the migration, phenotypic transformation and proliferation of VSMCs. MiR-128-5p directly targeted the 3′UTR binding sequences of p21 gene, negatively regulated p21 expression and exerted a role in the proliferation of VSMCs.Conclusion：Our research showed that the migration, phenotypic transformation and proliferation of ox-LDL-induced VSMCs were repressed by AA through inhibiting miR-128-5p via targeting p21 gene, which may provide an effective option for the treatment of Atherosclerosis.
Regulation of Nutritional Metabolism in Different Perinatal Period of Does: Energy Metabolism Efficiency, Lipid Metabolism, Oxidative Stress and Liver Metabolomics Profile in Response to Nicotinamide Supplementation
Authors: Wei Xiaoshi , Yin Qingyan , Zhao Huihui , He Jiajun , Cao Yangchun , Yao Junhu
Published: September 2020

Background: Improving energy efficiency is urgent during perinatal period because dairy ruminant is often in negative energy balance, resulting many metabolic disorders thus economic losses. It has been previously highlighted that nicotinamide (NAM) supplementation during perinatal period could benefit the energy balance, while the underlying metabolic alterations and the differences in NAM supplemented during different perinatal period have been poorly studied. This study aimed to elucidate the effects of NAM on energy efficiency, lipid metabolism, oxidative status, and liver metabolites profile of perinatal does during different perinatal period. Results: Fifteen multiparous does with similar parity, weight, and previous milk yield were paired and allocated to 3 groups (n = 5): control (C), postpartum supplementation (P, NAM supplemented after kidding), and entire-perinatal supplementation (EP, NAM supplemented from -21 to 28 d around kidding). Does were drenched with 5 g/d of NAM and slaughtered on d 28. The ruminal acetic acid tended to decrease, and the propionic acid and valeric acid were increased in P and EP. The does in P and EP had a decreased acetic acid to propionic acid ratio. Does in EP had higher liver mitochondrial respiratory chain complexes. The Complex Ⅱ was elevated in both P and EP and NAM supplementation tended to increase ATP production. Liver metabolomics analysis and tissues biochemical analysis revealed that lipid was decomposed in abdominal adipose, and in liver, the decomposition of lipid was more than the synthesis, and the amino acid metabolism were enriched by NAM. Moreover, the oxidative status of blood and liver were improved by NAM supplementation, and supplementation of NAM during postpartum only does not appear enough to cope with the metabolites of oxidative phosphorylation. Conclusions: Overall, these data suggested that NAM supplementation during perinatal period favored the rumen fermentation pattern to propionic acid-type, and improved liver energy efficiency with benefited lipid metabolism. The NAM supplemented from prepartum is needed for better oxidative status and energy metabolism of perinatal does.
Morphology, genetic characterization and molecular phylogeny of pinworm Skrjabinema longicaudatum sp. n. (Oxyurida: Oxyuridae) from the endangered Tibetan antelope Pantholops hodgsonii (Abel) (Artiodactyla: Bovidae)
Authors: Cao Yi-Fan , Chen Hui-Xia , Li Yang , Zhou Dang-Wei , Chen Shi-Long , Li Liang
Published: September 2020

Background

The Tibetan antelope Pantholops hodgsonii (Abel) (Artiodactyla: Bovidae) is an endangered and endemic species of mammal to the Qinghai-Tibetan Plateau. Parasites and their caused parasitic diseases are considered to be important threats in the conservation of the Tibetan antelope. However, our present knowledge of the composition of the parasites from the Tibetan antelope remains limited.

Methods

Large numbers of nematode parasites were collected from a dead Tibetan antelope. The morphology of these nematode specimens were observed using light and scanning electron microscopy. The nuclear and mitochondrial DNA sequences [i.e. small ribosomal DNA (18S), large ribosomal DNA (28S), internal transcribed spacer (ITS) and cytochrome c oxidase subunit 1 ( cox 1)] were amplified and sequenced for molecular identification. Moreover, phylogenetic analyses were performed using maximum likelihood (ML) inference based on 28S and 18S + 28S + cox 1 sequence data, respectively, in order to clarify the systematic status of these nematodes.

Results

Integrated morphological and genetic evidence reveals these nematode specimens to be a new species of pinworm Skrjabinema longicaudatum sp. n. (Oxyurida: Oxyuridae). There is no intraspecific nucleotide variation found between different individuals of S. longicaudatum sp. n. in the partial 18S, 28S, ITS and cox 1 sequences. However, the high level of nucleotide divergence was revealed between the new species and its congeners in 28S (8.36%) and ITS (20.3–23.7%) regions, respectively. Molecular phylogenetic results supported that the genus Skrjabinema should belong to the subfamily Oxyurinae (Oxyuroidea: Oxyuridae), instead of the subfamily Syphaciidae or Skrjabinemiinae in the traditional classification, which formed a sister relationship to the genus Oxyuris .

Conclusions

A new species of pinworm Skrjabinema longicaudatum sp. n. (Oxyurida: Oxyuridae) was described. Skrjabinema longicaudatum sp. n. represents the first species of Oxyurida (pinworm) and the fourth nematode species reported from the Tibetan antelope. Our results contribute to our knowledge on the species diversity of parasites from the Tibetan antelope, and also clarified the systematic position of the genus Skrjabinema .
Improve Management of Stress-related Mental Disorders in Chinese Medical Students: A Randomized Controlled Study
Authors: Rong Rong , Chen Wei , Dai Zihao , Gu Jingli , Chen Weiying , Zhou Yanbin , Xiao Haipeng , Kuang Ming
Published: September 2020

Background
Depression, burnout and reduced clinical empathy are the most prevalent mental disorders in medical students. Effective strategies to improving the situations are lacking. This study aimed to investigate the efficacy of teaching an interventional course tailored to the needs of senior Chinese medical students.
Methods
Our study enrolled a total of 146 senior medical students from Zhongshan School of Medicine, Sun Yat-sen University between March 2016 and June 2016 for analysis. The study designed an interventional course based on the preliminary data revealed by a pilot study group (5 pre-clinical students and 5 interns), and the control group got the traditional courses. Before and after the courses, our study required all students to complete five self-assessment questionnaires to evaluate the score of depression, burnout, empathy, self-efficacy (SE), and quality of life (QoL).
Results
After the courses, the interventional group had significantly higher empathy and QoL scores, compared to the control group (111.0 vs 106.0, P = .012, and 32 vs 29.5, P = .04, respectively). While depression scores in the interventional group were significantly lower than those in control group (P = .02). However, there were no significant differences in burnout and self-efficacy scores between both groups.
Conclusions
Our interventional course had a positive impact on the stress-related mental disorders of Chinese medical students, which may help provide novel information for incorporation into the “wellness curricula” of medical schools.