bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling the Longtiudnal Change of Viral Load of HIV Positive Patients on Antiretroviral Therapy
Authors: Getachew Dawit , Eshetie Aragaw , Chekole Dessie
Published: December 2020

HIV/AIDS continues to be a major public health concern and cause of death in the world. Even- though WHO recommended viral load testing as the preferred monitoring approach to diagnose and confirm ARV treatment failure, but in most cases, factors influencing the trend of viral load were not well identified. The main objective of this study was to modeling the change of viral load and identifying its associated factors among HIV positive patients. In this retrospective longitudinal data analysis, data was collected from 287 HIV positive patients registered for ART between January 2017 and June 2019 in Zewditu hospital and unstructured covariance structure was parsimonious for the data. linear mixed model with different random effect were applied to the data. Linear mixed model with random intercept and slope were selected as a best model to fit the data based on different model selection criteria. The findings of the study revealed that there was a decrement over time in the log VL of patients with HIV on ART. Furthermore, time, baseline CD4 count, WHO clinical stage, functional status of the patient, adherence, smoking status, initial ART Regimen and Time interaction with adherence and WHO stage were found to be significant predictors of log VL evolution. Therefore, Patients should take ART regimens with good adherence to decrease their viral load over time.
Back Pain and Related Factors in Patients with COVID-19
Authors: UZ CUMA , UMAY EBRU , GUNDOGDU IBRAHIM , UZ FATMA
Published: December 2020

Background: The aim of the study was to determine whether back pain is a clinical manifestation in patients with COVID-19, and to decide whether any demographic and disease characteristics might act as an effective indicator of back pain.Matherial and methods: Patients with COVID-19 (N: 99) were recruited from the infectious diseases department of a secondary care hospital and divided into two groups according to the presence or absence of back pain. The main outcomes included were demographic and disease characteristics, and the Nord-Trøndelag Health Study Physical Activity Level for Work (HUNT) 6-minute walking test (6MWT). Results: The most common symptoms were fatigue (n = 63, 63.6%), followed by back pain (n = 50, 50.5%). A sedentary lifestyle, oxygen requirement, the presence of pneumonia and typical pneumonia pattern were significantly higher (p = 0.009, p = 0.026, p = 0.001, p = 0.001, respectively), and aerobic capacity was lower (p = 0001) in patients with back pain. The presence of back pain continued to be associated with the presence of pneumonia and reduced aerobic capacity in multivariate analysis.Conclusions: Back pain may be associated with the presence and severity of COVID-19 pneumonia.
Sex Influence on Cardiovascular Autonomic Modulation and on Cardiac and Renal Oxidative Stress: Effects of Aerobic Exercise Training
Authors: Shimojo Guilherme Lemos , Stoyell-Conti Filipe , Dias Danielle , Barboza Catarina , Sartori Michelle , Bernardes Nathalia , Sanches Iris , Irigoyen Maria-Cláudia , ANGELIS KATIA DE
Published: December 2020

The aim of this study was to investigate the difference between sexes after 8 weeks of aerobic exercise training on cardiovascular autonomic modulation and oxidative stress. Wistar rats were distributed into (n = 8/group): sedentary male (SM), trained male (TM), sedentary female (SF) and trained female (TF). Arterial pressure (AP) signals were directly recorded. Cardiovascular autonomic modulation was evaluated by spectral analysis. Aerobic exercise training was performed on treadmill (5 days/wk; 8 wks). Oxidative stress was evaluated on cardiac and renal tissues. Both trained groups presented bradycardia. Exercise training increased heart rate variability (VAR-PI) and decreased cardiac sympathovagal balance in both sexes. Although, no differences observed in AP, the female groups showed a lower vascular sympathetic modulation than the male groups. There was a positive correlation between vascular sympathetic modulation and renal membrane lipid peroxidation (LPO) (r = 0.6, p < 0.01). LPO in cardiac tissue was reduced in the TM, SF and TF groups when compared to the SM group and it was correlated with cardiac sympathetic modulation (r = 0.6, p < 0.01). Only the TF group presented AP variability and renal LPO decreased and cardiac glutathione redox balance (GSH/GSSG) improved when compared to the other groups. Moreover, the trained females showed greater improvement on VAR-PI (~ 1.8 times), on cardiac and renal antioxidant capacity (TRAP: ~2,1 and ~ 1.5 times, respectively), and on cardiac GSSG (~ 2.8 times) than the trained males. In conclusion, female rats showed additional aerobic exercise training induced-cardiovascular autonomic modulation and target organs oxidative stress profile improvement than male rats.
A Semi-Parametric Analysis of Childhood Stunting in India: District Level Scenario
Authors: Sharma Palak , Banerjee Kajori , Dwivedi Laxmikant
Published: December 2020

BackgroundA growing body of literature has recognized the urgency of addressing the issue of childhood stunting (low height for age) in India and dedicated substantial resources to identifying the factors that are strongly associated with its considerable prevalence in the country. However, most of these studies have focused on parametric models with limited use of geographic information and prefixed assumption on the linear association of various factors with stunting outcomes. The present study re-investigates the non-linear association of certain covariates along with spatial effects by using a flexible Bayesian semi-parametric regression approach at the district level.MethodData is taken from the recent fourth round of the National Family Health Survey (NFHS 4, 2015-16). The analysis is based on the data from 2,24,190 children whose complete anthropometric measurements of weight and height are measured.ResultsThe paper has two major contributions. First, it challenges the pigeonholing of linear association of covariates. It identifies a non-linear association of child's age, mother's age at birth, and mother's BMI with childhood stunting. Children's height-for-age score worsens up to the age of 20 months and then stabilizes at a lower HAZ score in the states with a high prevalence of childhood stunting. Almost all high prevalence states display an inverted U association for maternal BMI suggesting that not just underweight mothers, but overweight mothers are also likely to have stunted children. Secondly, the results indicate high spatial clustering of poor performing districts in states with a high prevalence of childhood stunting. For example, the districts in the West of Bihar show significantly higher levels of childhood stunting than the ones in the East.ConclusionsThis is the first time that a flexible and realistic model has been applied to district-level data to identify regional variation and highlight the issues of pigeonholing linear association of all correlated of childhood stunting. The findings from the study is a novel attempt to rethink restrictive modeling approaches of various public health issues in a regionally diverse country such as India.
Prevalence of domestic violence in a time of catastrophic disease outbreaks including COVID 19 pandemic: A systematic review protocol
Authors: Abraham Gelila , Gelana Beshea , Yitbarek Kiddus , Morankar Sudhakar
Published: December 2020

Background
Domestic violence is a public health issue that has a long term and irreversible effect on the victims. There are vulnerable groups like children, women, and elders. The problem becomes worse for these populations in the time of catastrophic events including disease pandemic. However, few attempts have been made to systematically review the prevalence and pattern of domestic violence during these times all over the world.
Methods
An initial search of PubMed will be followed by CINAHL, Scopus, Google Scholar, Embase, and ProQuest Health. Titles and abstracts of studies will be reviewed, and full-text articles will be selected if the inclusion criteria are met. Studies that meet the eligibility criteria will then be assessed by two independent reviewers. Full-text articles will be selected if the inclusion criteria are met. A standardized critical appraisal checklist for studies reporting prevalence data will be used to assess methodological quality and a standardized data extraction tool will be used. The results from the included studies will be analyzed using JBI SUMARI software.
Discussion
This systematic review will provide a solid evidence on the magnitude of domestic violence of any forms during catastrophic disease outbreaks including the current pandemic, COVID-19.
Systematic review registration number:
The systematic review protocol registration number in PROSPERO is CRD42020192255.
Very Broadband Strain-Rate Measurements Along a Submarine Fiber-Optic Cable Off Cape Muroto, Nankai Subduction Zone, Japan
Authors: Ide Satoshi , Araki Eiichiro , Matsumoto Hiroyuki
Published: December 2020

Distributed acoustic sensing (DAS) is a new method that measures the strain change along a fiber-optic cable and has emerged as a promising geophysical application across a wide range of research and monitoring. Here we present the results of DAS observations from an submarine cable offshore Cape Muroto, Nankai subduction zone, western Japan. The observed signal amplitude varies widely among the DAS channels, even over short distances of only ~100 m, which is likely attributed to the differences in cable-seafloor coupling due to complex bathymetry along the cable route. Nevertheless, the noise levels at the well-coupled channels of DAS are almost comparable to those observed at nearby permanent ocean-bottom seismometers. Many earthquakes were observed during the five-day observation period, with the minimum and maximum detectable events being a local M1.1 event 30–50 km from the cable and a teleseismic Mw7.7 event that occurred in Cuba, respectively. Temperature appears to exert a greater control on the DAS signal than real strain in the quasi-static, sub-seismic range. We observed many rapid temperature change events migrating along the cable: a small number of large migration events (up to 10 km in 6 hours) associated with rapid temperature increases, and many small-scale events (both rising and falling temperatures). These events may reflect deep-ocean water mixing processes that are the result of ocean current–tidal interactions along an irregular seafloor boundary.
Short Term Selection to Diflubenzuron and Bacillus Thuringiensis Subsp. Israelensis Differentially Affects the Winter Survival of Culex Pipiens F. Pipiens and Culex Pipiens F. Molestus (Diptera: Culicidae)
Authors: Ioannou Charalampos S , Hadjichristodoulou Christos , Kyritsi Maria A , Papadopoulos Nikos T
Published: December 2020

BackgroundThe Culex pipiens mosquito consists of two forms named pipiens and molestus that exhibit substantial differences in their biology including overwintering behavior. Diflubenzuron (DFB) and Bacillus thuringiensis subsp. israelensis (Bti) are among the most widely used larvicides for controlling Cx. pipiens populations. The high dependency on these two larvicides, pose major concerns for resistance development. The evolution and stability of tolerance/resistance to insecticides has been associated with fitness costs that may be manifested under stressful conditions such as the winter period. This study aimed to investigate how short term selection of pipiens and molestus forms to both larvicides affect their susceptibility and their overwintering success.MethodsColonies of both forms of Cx. pipiens were established from the same area. Following standard protocols, the efficacy of both larvicides was determined for each mosquito population. Then, larvae from each form, were selected for three successive generations by applying fixed doses corresponding to IE80 (Inhibition of adult Emergence) and LC80 (Lethal Concentration) for DFB and Bti, respectively. At the end of this process, the susceptibility levels and the winter survival of the selected populations relative to controls (colonies that received no selection) were determined.ResultsContrary to Bti, selection with DFB induced different susceptibility levels between the two forms of Cx. pipiens. The selected populations of Cx. pipiens f. molestus to both larvicides exhibited a high fitness cost in terms of reduced winter larval survival rates relative to control. Moreover, the obtained adults of the Bti selected population experienced significantly shorter lifespan compared to control and DFB selected population. On the other hand, selection with both DFB and Bti had no apparent effects on Cx. pipiens f. pipiens female winter survival rates relative to control. Furthermore, the reproductive parameters and the longevity of the overwintered females were similar between the selected populations and the control. ConclusionsOur findings reveal that sort term selection to DFB and Bti induces a high fitness cost on the winter survival of Cx. pipiens f. molestus but not of pipiens form, suggesting potential differences on the persistence of tolerant individuals from year to year between the two forms.
Single-Cell Transcriptomic Landscape Reveals the Differences in Cell Differentiation and Immune Microenvironment of Papillary Thyroid Carcinoma Between Genders
Authors: Peng Miaoguan , Wei Guohong , Zhang Yunjian , Li Hai , Lai Yingrong , Guo Yan , Chen Yuxin , Liu Liehua , Xiao Haipeng , Guan Hongyu , Li Yanbing
Published: December 2020

BackgroundPapillary thyroid carcinoma (PTC) is the main pathological type of thyroid carcinoma (TC). Gender is a prominent background parameter for patients with PTC. Here, we aimed to delineate the differences in cell clusters and immune microenvironment in relation to gender in PTC.ResultsMalignant epithelial cells were divided into two distinct subsets in male and female patients with PTC. Moreover, significant differences involving copy-number variations (CNVs), gene profiles, and cell differentiation were detected between male and female patients. Regarding the interactions of fibroblasts and endothelial cells with malignant epithelial cells, members of the human leukocyte antigen (HLA) family and their receptors were considered as typical in female patients with PTC, while transforming growth factor beta 1 (TGFB1) and its receptors were typical of male patients with PTC. The characteristics of B cells, including cell clusters, cell differentiation, and dominant gene sets, were significantly different between genders. ConclusionsOur data revealed the detailed differences in cell clusters and immune microenvironment in PTC according to gender at the single-cell level, which provided new insights into the understanding of the impact of gender on PTC.
Trained Immunity Induced by in Vivo Peptide-Based STAT6 Inhibition Prevents Ragweed Allergy in Mice
Authors: Michael Husheem , Li Yuanyi , Wang Yufa , McCusker Christine T.
Published: December 2020

BackgroundAllergic airways disease (AAD) is initiated, maintained by the type 2 (T2) inflammatory pathway, and is partially regulated by cytokines IL-4 and IL-13 following activation of the STAT6 transcription factor. ObjectiveTo investigate mucosal immune responses, using neonatal vaccination with the STAT6 inhibitory peptide (STAT6-IP), to prevent the development of ragweed-induced AAD. MethodsWe demonstrate that transfer of CD4+ T cells or dendritic cells (DC) from STAT6-IP vaccinated wild-type BALB/c mice to naïve mice, that were subsequently chronically exposed to sensitizing doses of ragweed allergen, is sufficient to prevent development of T2 responses in recipients. ResultsOur results demonstrate significant reductions in; airways hyperresponsiveness (AHR); ragweed-specific IgE; pulmonary inflammation; T2 cytokines; and inflammatory gene expressions in recipient mice. Expression of IDO, TGFβ and T regulatory cells were all significantly increased. Anti-TGFβ treatment during the ragweed sensitization phase re-constituted the pro-inflammatory T2 immune response. We show that tolerance can be attained via DC or T cells trained in the STAT6-IP-mediated tolerant milieu. This effect is not restricted to a particular allergen and does not require antigen-mediated T cell activation prior to transfer. ConclusionThese data indicate that early transient STAT6-inhibition constitutes an effective immunomodulatory airways allergy preventative strategy.
Elevated Exosome-derived Mirnas Predict Osimertinib Resistance in Non-small Cell Lung Cancer
Authors: Li Xinying , Chen Cen , Wang Zimu , Liu Jiaxin , Sun Wei , Shen Kaikai , Lv Yanling , Zhu Suhua , Zhan Ping , Lv Tangfeng , Song Yong
Published: December 2020

Background: Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations will inevitably develop drug resistance after being treated with the third-generation EGFR-tyrosine kinase inhibitor (TKI), osimertinib. In recent years, many studies have been focusing on the ability of exosomal miRNAs secreted by tumor cells to transmit resistance information. However, the mechanism of exosome-derived miRNAs in osimertinib resistance remains unexplored.Methods: We extracted and sequenced exosomes from the supernatant of the osimertinib-resistant cell line, H1975-OR, and the sensitive cell line, H1975. The results were compared with plasma exosome sequencing before and after the appearance of drug resistance in three NSCLC clinical patients treated with oral osimertinib. Exosome-derived miRNAs that had significantly increased expression levels after osimertinib resistance were screened for expanded validation in other 64 NSCLC patients.Results: Cluster analysis of the target genes revealed that exosomal miRNAs participate in osimertinib resistance mechanisms through the activation of bypass pathways (RAS-MAPK pathway abnormality and PI3K pathway activation). Exosome-derived miR-184 (p = 0.0325) and miR-3913-5p (p = 0.0169) expression levels increased significantly after the onset of osimertinib resistance. Exosomal miR-184 was correlated with lactate dehydrogenase levels (p = 0.018). Exosomal miR-3913-5p was associated with TNM stage (p = 0.045), platelet count (p = 0.024), tumor marker carcinoembryonic antigen (p = 0.045), and distant metastases (p = 0.049), especially bone metastasis (p = 0.03). In the subgroup of patients with EGFR exon 21 L858R point mutation, miR-184 (p = 0.0104) and miR-3913-5p (p = 0.0085) derived from serum exosomes had both significantly increased expression levels. In the subgroup of T790M-positive patients, miR-3913-5p derived from serum exosomes may also be a good indicator of osimertinib resistance (p = 0.013).Conclusions: The expression levels of miR-184 and miR-3913-5p derived from exosomes in the peripheral blood of NSCLC patients could be used as biomarkers to indicate osimertinib resistance.
Effects of Metformin on Reproductive, Endocrine, and Metabolic Characteristics of Female Offspring in a Rat Model of Letrozole-induced Polycystic Ovarian Syndrome With Insulin Resistant
Authors: Xie Yidong , Xiao Li , Shi Xiaohan , Zhao Yifan , Li Xiaohong , Wang Yan , Qin Lang , Li Shangwei
Published: December 2020

Background: Polycystic ovary syndrome (PCOS) is a complex and heterogeneous endocrine disorder that has many characteristic features including hyperandrogenemia, insulin resistance and obesity. The beneficial effects of metformin on reproduction, metabolism and endocrine, especially with the capacity to ameliorate insulin resistance (IR) in polycystic ovary syndrome (PCOS), place it as a good alternative for its widely prescribed, but its association with PCOS offspring remains uncertain. We aim to investigate the impact of metformin on reproductive, endocrine and metabolic characteristics in female offspring born to letrozole-induced PCOS-IR rats.Methods: 45 female wistar rats were implanted with letrozole-continuous-release pellets or placebo, subsequently treated with metformin or vehicle control, then mated with healthy male wistar rats. Estrous cycle, endocrine hormone profile, fasting insulin measurements and glucose tolerance test have been investigated and the expression of INSR in pancreas, FSHR and LHCGR in ovaries have been analyzed with Quantitative Real-time Polymerase Chain Reaction and Western Blotting assay.Results: Decreased conception rate and increased multiple pregnancy rates were found in PCOS-IR rats, which significantly improved after metformin treatment. Metformin significantly decreased the risk of body weight gain and increased INSR expression of pancreas in female F1 offspring in PCOS-IR rats. Decreased FSHR and increased LHCGR expressions in ovary were observed in female F1 rats of PCOS-IR and PCOS-IR+Met group. Nevertheless, there were no significant differences of INSR, FSHR and LHCGR expressions in female F2 offspring of PCOS-IR rats, as well as other PCOS phenotypes.Conclusions: The current study indicates that widespread reproductive, endocrine and metabolic changes in letrozole induced PCOS-IR rat model, but those PCOS phenotypes could not be inherit to offspring generations stably. Metformin may contribute to improve obesity, hyperinsulinemia and insulin resistance of female F1 offspring in PCOS-IR. The results of this study can be used as a theoretical basis for supporting metformin-using in the treatment of PCOS-IR patients.
Towards A Comprehensive Breastfeeding-Friendly Workplace Environment: Insight From Selected Health Facilities In The Central Region of Ghana
Authors: Nkrumah Jacqueline N/A , Abuosi Aaron Asibi , Nkrumah Rodney Buadi
Published: December 2020

Background In the last three decades, Ghana has championed the objectives of the Baby Friendly Hospital Initiative to provide pregnant women and nursing mothers with skills and support necessary for optimal breastfeeding. Yet, little is known about practical interventions to promote breastfeeding friendly work environment in healthcare facilities. This study explores the extent to which healthcare facilities in Effutu Municipality provide breastfeeding friendly workplace environment to breastfeeding frontline health workers. Methods A descriptive mixed-method approach was employed to collect data from healthcare facility representative and breastfeeding frontline health workers. Self-administered questionnaire with structured responses and interview guide were used to collect data. Thematic analysis was used to analyze interview responses. Survey responses were processed with SPSS version 23.0 and presented using frequencies and percentages.Results Three main themes, namely, Standpoints on workplace breastfeeding support; Breastfeeding support, suggested future directions and six sub-themes, including backings for workplace breastfeeding support; perceived benefits of breastfeeding support; factors of poor breastfeeding workplace support; maternity protection benefits; workplace support gaps, and awareness creation on benefits were identified to explain the extent to which health facilities provide breastfeeding friendly workplace environment. Breastfeeding frontline health workers said their hospitals have no breastfeeding policy (96%), no breastfeeding facility (96%), do not go to work with baby (96%), but went on 12 weeks maternity leave (96%) and work half-day (70%) on return to work.ConclusionHealth facilities in the study do not provide breastfeeding friendly work environment except the privileges provided by the Labor Act. Continuous advocacy on breastfeeding workplace support and stakeholder engagement to build consensus on the mix of strategies suitable to cushion breastfeeding frontline health workers against work-breastfeeding stress and minimize its negative impact on optimal breastfeeding among frontline health workers is recommended.
Investigating Health Status Among Women Aged 50-70 years old in Hunan Province, China: A Cross-Sectional study
Authors: Luo Yang , Min NIE , Yan-ting MENG , Chen XU , Si QIN , Ling FAN , Jing YUE
Published: December 2020

Background: As promotion of the Global strategy and action plan on ageing and health 2016-2020 and the Outline of the "Healthy China 2030" Plan, healthy ageing becomes a hot pot. It is crucial to identify health status of senior women and acquire characteristics of them. The purpose of this paper was to investigate the health of women aged 50-70 in Hunan Province of China, come out coping strategy and prompt an active discussion for healthy ageing.Methods: A cross-sectional study was conducted in 20 communities randomly selected from 5 sampled districts and 5counties in Hunan Province. A self-designed and structured questionnaire was used, included demographic data, diseases-related information, self-reported health, health behaviors, and psychological health. The data was collected by well-trained workers, double-entered into EpiData 3.0 and analyzed by SPSS 19.0.Results: Among the 2585 senior women, 51.0% was chronic diseases, 49.6% was gynecopathy and 23.6% was mastopathy. Age [OR=1.394, 95% CI=(1.63-1.670)], household type [OR=1.700, 95% CI=(1.416-2.042)], BMI [OR=1.194, 95% CI=(1.043-1.367)], average monthly household income [OR=0.884, 95% CI=(0.809-0.965)] and self-reported physical health [OR=4.659, 95% CI=(3.913-5.546)] were significantly associated with chronic diseases. Age [OR=0.668, 95% CI=(0.564-0.792)], household type [OR=1.335, 95% CI=(1.094-1.629)], occupation [OR=1.045, 95% CI=(1.002-1.090)], average monthly household income [OR=1.243, 95% CI=(1.143-1.352)] and self-reported physical health [OR=1.748, 95% CI=(1.510-2.024)] were significantly associated with gynecopathy. Age [OR=0.749, 95% CI=(0.616-0.910)], household type [OR=1.603, 95% CI=(1.269-2.026)], occupation [OR=1.057, 95% CI=(1.009-1.108)], average monthly household income [OR=1.233, 95% CI=(1.127-1.350)] and self-reported physical health [OR=1.272, 95% CI=(1.077-1.502)] were significantly associated with mastopathy. Age [OR=0.778, 95% CI=(0.645-0.939)], household type [OR=2.090, 95% CI=(1.733-2.520)], and BMI [OR=1.218, 95% CI=(1.061-1.399)] were significantly associated with exposure to secondhand smoke. Age [OR=0.829, 95% CI=(0.701-0.980)] and occupation [OR=0.956, 95% CI=(0.923-0.990)] were significantly associated with regular physical examinations. Household type [OR=0.642, 95% CI=(0.398-1.035)] and self-reported physical health [OR=1.983, 95% CI=(1.340-2.935)] were significantly associated with anxiety.Conclusion: This cross-sectional study shows good description as an appropriate investigation for the identification of women aged 50-70 with certain diseases, health behaviors and psychological health problems in a representative and community-conducted sample of women in Hunan Province of China. It discloses their poor health status.
Economic Conditions and Mental Health in Thailand
Authors: Lerskullawat Attasuda , Puttitanun Thitima
Published: December 2020

BackgroundThere is a continual rise in the number of people suffered from mental disorder around the world. Several factors are believed to be connected to the development of mental disorders. Apart from health factors, mental disorders could also be caused by the economic and social factors associated with the patients. However, none of the existing literature has provided the analysis by taking into account all the possible causes together. This paper attempts to fill this gap in the literature by ascertaining the relationship between economic and social factors in relation to mental disorders.MethodsUsing the number of mental disorder cases in all 77 provinces in Thailand during the period 2015 to 2017, this paper uses either a fixed effects or a random effects model, depending on the results of the Hausman test, to analyse the effect of economic and social factors on the number of mental disorder cases in Thailand.ResultsGenerally, we found that better economic situations, as measured by higher GPP per capita, higher employment rates and lower household debt, help reduce mental disorder rates, while social factors such as greater health service accessibility and lower technology accessibility also reduce the number of mental disorder cases. However, death and divorce rates are not consistent in their effect on mental disorder rates, their impact seeming to depend on what type of mental disorder is being considered. ConclusionsWhen considering different types of disorders, we found that they could be affected by each of these factors in different ways.
Socio-Economic Consequences of Mental Distress: Quantifying the Impact of Self-Reported Mental Distress on the Days of Incapacity to Work and Medical Costs in the Following 2 years: A Longitudinal Study in Germany
Authors: Müller Gerhard , Bombana Manuela , Heinzel-Gutenbrenner Monika , Kleindienst Nikolaus , Bohus Martin , Lyssenko Lisa , Vonderlin Ruben
Published: December 2020

Background: Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span.Method: Within a longitudinal research design, 2,287 study participants' mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Days of incapacity to work and medical costs were retrieved from a German health insurance’s routine data during the following two-year period.Results: Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs is also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions: Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.
Midday Meals as an Early Childhood Nutrition Intervention: Evidence from Plantation Communities in Sri Lanka
Authors: Perera Udeni De Silva , Inder Brett A.
Published: December 2020

Background: High rates of child malnutrition are a major public health concern in developing countries, particularly among vulnerable communities. Midday meals programs can be effective for combatting childhood malnutrition among older children. However, their use in early childhood is not well documented, particularly within South Asia. Anthropometric measures and other socioeconomic data were collected for children below the age of five years living in selected Sri Lankan tea plantations, to assess the effectiveness of midday meals as a nutrition intervention for improving growth among young children.Methods: The study exploits a natural experiment whereby the provision of the midday meals program is exogenously determined at the plantation level, resulting in comparable treatment and control groups. Longitudinal data is regularly collected on heights and weights of children, between 2013-2015. Standardized weight-for-age, height-for-age, BMI-for-age and weight-for-height are calculated following WHO guidelines, and binary variables for stunting, wasting and underweight are constructed. All modelling uses STATA SE 15. Random-effects regression with instrumental variables is used for modelling standardized growth variables whilst random-effects logistic regression is used for binary outcome variables. Robustness analysis involves different estimation methods and subsamples. Results: The dataset consists of longitudinal data from a total of 1279 children across three tea plantations in Sri Lanka, with 799 children in the treatment group and 480 in the control group. Results show significant positive effects of access to the midday meals program, on the growth of children. A child with access to the midday meals intervention reports an average standardized weight-for-age 0.03 (±0.01) and height-for-age 0.05 (±0.01) units higher than a similar child without access to the intervention. Importantly, access to the intervention reduces the likelihood of being underweight by 0.45 and the likelihood of wasting by 0.47. The results are robust to different model estimations and across different subsamples by gender, birthweight and birth-year cohort. Qualitative data analysis suggests a high viability of implementing similar programs within tea plantations in Sri Lanka.Conclusions: Midday meals programs targeting early childhood can be an effective intervention to address high rates of child malnutrition, particularly among vulnerable communities in developing countries like Sri Lanka.
Change in Work-Related Income Following the Uptake of Treatment for Mental Disorders Among Young Migrant Women in Norway: A National Register Study
Authors: Hynek Kamila Angelika , Straiton Melanie Lindsay , Hollander Anna-Clara , Liefbroer Aart , Hauge Lars Johan
Published: December 2020

Background: Mental disorders are associated with several work-related outcomes such as loss of income. However, studies investigating the effect of mental disorders on work-related income by migrant background are lacking. This study aimed to assess the change in work-related income following the uptake of outpatient mental healthcare (OPMH) treatment, a proxy for mental disorder, in young women with migrant background. Additionally, we looked at how this varied by income level.Methods: This study makes use of data from several national registries. The study population consisted of women aged 23-40 years residing in Norway for at least three consecutive years between 2006 and 2013 (N=640,527). By using a stratified linear regression with individual fixed effects, we investigated differences between the majority women, descendants and eight migrant groups. Interaction analysis was conducted in order to examine the differences in income loss following the uptake of OPMH treatment among women with and without migrant background. Results: Results show that OPMH treatment was associated with a decrease in income for all groups. However, the negative effect was stronger among those with low income. Only migrant women from EU Eastern Europe with a high income were not significantly affected following OPMH treatment. Conclusions: Experiencing a mental disorder during a critical age for establishment in the labour market may not only affect income but also subsequent workforce participation and dependency on social welfare services, regardless of migrant background, resulting in large economic costs for both the individual and for the society as a whole.
New neural network classification method for individuals ancestry prediction from SNPs data
Authors: Soumare Harouna , Rezgui Sadok , Benkahla Alia , Gmati Nabil
Published: December 2020

Artificial Neural Network (ANN) algorithms have been widely applied to genomic prediction data. Single Nucleotide Polymorphisms(SNPs) represent the most common genetic variations of human genome, it has been shown that they are implicated in many human diseases and they can be used to predict genetic diseases such as diabetes. Developing ANN techniques to handle such kind of data can be considered as a great success in medical field. However, the high dimensionality of genomic data and availability of only a few number of samples can make learning task very complicated. In this work, we propose a New Neural Network classification method based on input perturbation. The idea is first to use SVD to reduce the dimensionality of input data and train a classification network which prediction errors are then reduced by perturbing the SVD projection matrix. The proposed method has been evaluated on individuals genetic ancestry prediction dataset, the experimental results show the efficiency of proposed method. Reaching up to 96.23% of classification accuracy, this approach exceeds the previous deep learning approach evaluated on the same dataset.
Identification of Transmission Chains and Clusters Associated with COVID-19 in Tunisia
Authors: Safer Mouna , Letaief Hejer , Hechaichi Aicha Hechaichi , Harizi Chahida , Dhaouadi Sonia , Bouabid Leila , Darouiche Sondes , Gharbi Donia , Elmili Nawel , Salah Hamida Ben , Hammami Mongi , Talmoudi Khouloud , Moussa Rim , Chraa Nejib , Termiz Hasna , Ltaief Fethi , Tounekti Habib , Makhlouf Mohamed , Belgu Asma Sriha , Fredj Manel Ben , Khalfallah Sonia , Jabrane Houcine , Mchirgui Selma , Amich Chedli , Dabghi Radhia , Anez Zid , Abdelkader Latifa , Mhamdi Moncef , Ouerfeli Nabil , Zoghlami Salah , Bougatef Souha , Chahed Mohamed Kouni , Alaya Nissaf Bouafif Ben
Published: December 2020

Background: The aim of this study was to characterize the transmission chains and clusters of COVID-19 infection in TunisiaMethods: All cases were confirmed by RT-PCR of a nasopharyngeal specimen. Contact tracing is undertaken for all confirmed cases in order to identify close contacts that will be systematically screened and quarantined. Transmission chains were identified based on field investigation, contact tracing, results of screening tests and by assessing all probable mode of transmission and interactions.Results: As of May 18, 2020, 656 cases out of a total of 1043 confirmed cases of COVID-19 belong to 127 transmission chains identified during the epidemic (mean age 42.36 years, Standard deviation 19.56 and sex ratio 0.86). The virus transmission is the most concentrated in the governorate of Tunis (31.5%), Ariana (10.2%) and Ben Arous (10.2%). Virus transmission occurred 50 times (9.72% of secondary transmission events) between two different governorates. A maximum of seven generations of secondary infection was identified, whereas 62% of these secondary infections belong the first generation. A total of 11 “superspreader” cases were identified in this investigation. Four large clusters have been identified. The evolution of secondary cases highlighted two peaks: one in 2nd April and a second in 16 th April whereas imported cases caused local transmission of virus during the early phase of the epidemic.Conclusion: Correct contact tracing and early active case finding is useful to identify transmission chains and source of infection in order to contain the widespread transmission in the community.
SlGT11 Controls Floral Organ Patterning and Floral Determinacy in Tomato
Authors: Yang Liling , Qi Shilian , touqeer Arfa , Li Haiyang , Zhang Xiaolan , Liu XiaoFeng , wu shuang
Published: December 2020

Background: Flower development directly affects fruit production in tomato. Despite the framework mediated by ABC genes have been established in Arabidopsis, the spatiotemporal precision of floral development in tomato has not been well examined.Results: Here, we analyzed a novel tomato stamenless like flower (slf) mutant in which the development of stamens and carpels is disturbed, with carpelloid structure formed in the third whorl and ectopic formation of floral and shoot apical meristem in the fourth whorl. Using bulked segregant analysis (BSA), we assigned the causal mutation to the gene Solanum lycopersicum GT11 (SlGT11) that encodes a transcription factor belonging to Trihelix gene family. SlGT11 is expressed in the early stages of the flower and the expression becomes more specific to the primordium position corresponding to stamens and carpels in later stages of the floral development. Further RNAi silencing of SlGT11 verifies the defective phenotypes of the slf mutant. The carpelloid stamen in slf mutant indicates that SlGT11 is required for B-function activity in the third whorl. The failed termination of floral meristem and the occurrence of floral reversion in slf indicate that part of the C-function requires SlGT11 activity in the fourth whorl. Furthermore, we find that at higher temperature, the defects of slf mutant are substantially enhanced, with petals transformed into sepals, all stamens disappeared, and the frequency of ectopic shoot/floral meristem in fourth whorl increased, indicating that SlGT11 functions in the development of the three inner floral whorls. Consistent with the observed phenotypes, it was found that B, C and an E-type MADS-box genes were in part down regulated in slf mutants.Conclusions: Together with the spatiotemporal expression pattern, we suggest that SlGT11 functions in floral organ patterning and maintenance of floral determinacy in tomato.
Heart rate and swimming activity as indicators of post-surgical recovery time of Atlantic salmon (Salmo salar)
Authors: Føre Martin , Svendsen Eirik , Økland Finn , Gräns Albin , Alfredsen Jo Arve , Finstad Bengt , Hedger Richard , Uglem Ingebrigt
Published: December 2020

Background: Fish telemetry using electronic transmitter or data storage tags has become a common method for studying free-swimming fish both in the wild and in aquaculture. However, fish used in telemetry studies must be handled, anaesthetised and often subjected to surgical procedures to be equipped with tags, processes that will shift the fish from their normal physiological and behavioural states. In many projects, information is needed on when the fish has recovered after handling and tagging so that only the data recorded after the fish has fully recovered are used in analyses. We aimed to establish recovery times of adult Atlantic salmon (Salmo salar) after an intraperitoneal tagging procedure featuring handling, anaesthesia and surgery. Results: Based on ECG and accelerometer data collected with telemetry from nine individual Atlantic salmon during the first period after tagging, we found that heart rate was initially elevated in all fish, and that it took an average of ≈4 days and a maximum of 6 days for heart rate to return to an assumed baseline level. One activity tag showed no consistent decline in activity, and two others did not show strong evidence of complete recovery by the end of the experiment: baseline levels of the remaining tags were on average reached after ≈ 3.3 days. Conclusion: Our findings showed that the Atlantic salmon used in this study required an average of ≈ 4 days, with a maximum interval of 6 days, of recovery after tagging before tag data could be considered valid. Moreover, the differences between recovery times for heart rate and activity imply that recovery time recommendations should be developed based on a combination of indicators and not just on e.g. behavioural observations.
Pulmonary rehabilitation to improve physical capacity, dyspnea and quality of life following pulmonary embolism (the PeRehab study): Study protocol for a two-centre randomized controlled trial
Authors: Haukeland-Parker Stacey , Jervan Øyvind , Johannessen Hege Hølmo , Gleditsch Jostein , Stavem Knut , Steine Kjetil , Spruit Martijn A , Holst Rene , Tavoly Mazdak , Klok Erik , Ghanima Waleed
Published: December 2020

Background: Recently, a large group of patients with persistent dyspnea, poor physical capacity and reduced health-related quality of life (HRQoL) following pulmonary embolism (PE) has been identified and clustered under the name “post pulmonary embolism syndrome” (PPS). These patients seem good candidates for pulmonary rehabilitation. The aim of the study is to explore whether a pulmonary rehabilitation program can improve physical capacity, dyspnea and HRQoL in PPS patients.Methods: A two-centre randomized controlled trial (RCT) is being performed at Østfold Hospital and Akershus University Hospital in Norway. Patients with PPS are 1:1 randomized into an intervention or a control group. The intervention consists of a supervised, outpatient rehabilitation program twice weekly (1 hour) for 8 weeks provided by experienced physiotherapists. The intervention involves individually adapted exercises based on existing pulmonary rehabilitation programs (relaxation, interval and resistance training), and an educational session including topics such as normal anatomy and physiology of the respiratory and circulatory system, information on PE/PPS, breathing strategies, and benefits of exercise/physical activity. Patients randomized to the control group receive usual care without specific instructions to exercise.Participants in the intervention and control groups will be compared based on assessments conducted at baseline, 12 weeks and 36 weeks after inclusion using the incremental shuttle walk test (primary outcome) and endurance shuttle walk test (exercise capacity), Sensewear activity monitor (daily physical activity), the Modified Medical Research Council scale, the Shortness of Breath questionnaire (dyspnea), and EQ-5D-5L and the Pulmonary Embolism Quality of Life Questionnaire (HRQoL).Recruitment of 190 patients is currently ongoing.Discussion: Results from this study may provide a currently untreated group of PPS patients with an effective treatment resulting in reduced symptoms of dyspnea, improved exercise capacity and better HRQoL following PE.Trial registration: NCT03405480, Clinical Trials (registered prospectively.Protocol version 1 (from original protocol September 2017).The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 1).
Perception of childbirth experiences of Japanese women in Bali, Indonesia: A qualitative study
Authors: Tanaka Kazuko , Kurniasari Ni Made Dian , Widyanthini Desak Nyoman , Suariyani Ni Luh Putu , Listyowati Rina , Urayama Akimi , Wirawan I Made Ady , Yoshimura Koichi
Published: December 2020

Background: Maternal healthcare services in Indonesia have seen dramatic improvements over the past 25 years and yet there is still room for improvement. The perception, by the women, of the perinatal care provided, is a vital input to further improving these services. This study examines how the perinatal care provided is experienced by Japanese women in Bali, using an interview survey.Methods: We conducted semi-structured interviews, from August to October 2017, with 14 Japanese women living in Badung Regency and Denpasar City in Bali Province, Indonesia to report their perception of the perinatal care they experienced during their pregnancies. The interview guide included among others, the reasons for choosing specific (perinatal care) health facilities and their satisfaction with their experience of using the antenatal, delivery, and postnatal care services. The data were analysed using the qualitative content analysis method.Results: From the interview data, 12 categories across five themes were extracted. Participants reported experiencing various concerns during their pregnancies such as difficulty in obtaining perinatal care related information. From the beginning of their pregnancies, participants gradually established trusting relationships with midwives, but in many situations, they were disappointed with their childbirth experiences, as they felt that the care provided was not woman-centred. Through their own efforts and with the support of family members and other Japanese residents, many women were able to eventually regard their childbirth experiences as positive. Nevertheless, some women could not overcome their negative impressions even years after childbirth.Conclusions: Participants desired close attention and encouragement from nurses and midwives. Our results suggest that Japanese women in Bali expected a woman-centred perinatal care and active support from nursing/midwifery staff during their pregnancies and postnatal care.