bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome Analysis of the Transdifferentiation of canine BMSCs into Insulin Producing Cells
Authors: WANG JINGLU , Dai Pengxiu , Zou Tong , Lv Yangou , Zhao Wen , Zhang Xinke , Zhang Yihua
Published: July 2020

Background Bone marrow mesenchymal stem cells are a potential resource for the clinical therapy of certain diseases. Canine, as a companion animal, living in the same space with human, is an ideal new model for human diseases research. Because of the high prevalence of diabetes, our study in the alternative source of islets from bone marrow mesenchymal stem cells appears to be important.Result In this study, we completed the transdifferentiation process and achieved the transcriptome profiling of five samples with two biological duplicates, namely, “BMSCs”, “islets”, “stage1”, “stage2” and “stage3”. A total of 11,530 differentially expressed transcripts were revealed in the profiling data. The enrichment analysis of differentially expressed genes revealed several signaling pathways that are essential for regulating proliferation and transdifferentiation, including focal adhesion, ECM–receptor interaction, tight junction, protein digestion and absorption, and the Rap1 signaling pathway. Meanwhile, the obtained protein–protein interaction network and functional identification indicating involvement of three genes, somatostatin receptor 2, ribosomal protein S6 kinase A6, and vasoactive intestinal peptide, could act as a foundation for further research.Conclusion In conclusion, to the best of our knowledge, this is the first survey of the transdifferentiation of canine BMSCs into insulin-producing cells according with the timeline using next-generation sequencing technology. The three key genes we pick out may regulate decisive genes during the development of pancreas.
Results from the First Kuwait National Bariatric Surgery Report
Authors: Al-Sabah Salman , Haddad Eliana Al , Jumaa Taleb , Abbad Jassim Al , Salam Fareed , Abbas Mustafa , Kandari Mubarak Al , Ozairi Aws Al
Published: July 2020

Background: Currently, more than 30% of the population in the gulf demonstrate a body mass index(BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait.Methods: Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data.Results: The average age for participants was 32.6 years. The average preoperative BMI was 45.9kg/m2 for males and 43.3kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females(90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding(1.5%), with Roux-en-Y gastric bypass(RYGB) having the highest recorded rate of post-operative complications(3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB(10.3%) and lowest post-sleeve gastrectomy(2.5%).Conclusion: The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery.
The association of MTHFR A1298C polymorphism with cervical cancer: An Updated Meta-Analysis Involving 2835 Subjects
Authors: Mu Chunyan , Wang Zhongcheng , Wang Yue , Li Ying , Gu Bing , Ma Ping , Lan Ting
Published: July 2020

Background Published data have reported the relationships between MTHFR A1298C polymorphisms and cervical cancer susceptibility. However, the conclusions of these findings lack consistency.Methods A comprehensive literature search was performed using Web of Science, PubMed, EMBASE, Cochrane library, Wan Fang and CNKI databases. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation of MTHFR A1298C polymorphism and cervical cancer risk. Fixed-effects or random effects models was adopted according to heterogeneity test.Results A total of nine studies (1145 cases and 1690 controls) were included in this meta-analysis. Pooled data revealed that MTHFR A1298C polymorphism was significantly associated with an increased risk of cervical cancer in the allele model (P=0.028); the recessive model (P=0.028); and the heterozygous model (P=0.031).Conclusions Our results revealed that MTHFR A1298C polymorphism was associated with risk of cervical cancer.
Mental Health Planning During the COVID-19 Crisis: A Systematic Review of Online International Strategies and Recommendations
Authors: Almeda Nerea , Garcia-Alonso Carlos R. , Salvador-Carulla Luis
Published: July 2020

Background
Mental Health care systems have been dramatically affected by COVID-19. Containment measures have been imposed with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorders incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19.
Methods
A new questionnaire has been developed to identify the existence of common patterns in the selected documents. Questions were classified in three domains: COVID-19 information, mental health strategies and mental health recommendations. The PRISMA statements were adapted to review online documents. A two-steps cluster analysis was carried out to highlight underlying behaviors in data (patterns). Results were shown by using spider graphs (pattern profiles). Multidimensional links between questions were identified and assessed by conceptual maps.
Results
26 documents were included in the review. The questionnaire assessed document complexity and identified key mental health issues (i.e. tools for dealing with stress, depression and anxiety), which show a high agreement level among them. Cluster analysis highlighted the existence of common patterns in the selected question domains. Strong relationships between individual questions were also identified such as, for example, include psychological tips for maintaining good mental health and coping with COVID-19 (question nº 4), describe some psychological skills to help people cope with anxiety and worry about COVID-19 (question nº 6) and, finally, promote social connection at home (question nº 8).
Conclusions
When fast results are needed to develop health strategies and policies, rapid reviews associated to statistical and graphical methods are essential. Results obtained from the proposed analytical procedures are relevant to a) classify the documents about the psychological impact of COVID-19, b) develop new documents according to the selected objectives for matching population needs, c) improve psychological interventions in a pandemic, and d) adapt new documents to local situations. The relevance of adapting e-mental health to community mental health care model principles was highlighted. For developing e-mental health potential, some problems related to the digital gap, stigma and ethical issues must be considered.
Early detection of cervical cancer in western Kenya: Determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding
Authors: Mwaliko Emily , Hal Guido Van , Bastiaens Hilde , Dongen Stefan Van , Gichangi Peter , Otsyula Barasa , Naanyu Violet , Temmerman Marleen
Published: July 2020

Background
In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers’ behaviour in examining women who present with abnormal discharge or bleeding
Methods
This was a cross-sectional survey using the theory of planned behaviour (TPB). A sample of primary health care practitioners in western Kenya completed a 59-item questionnaire. Structural equation modelling was used to identify the determinants of providers’ intention to perform a gynaecological examination. Bivariate analysis was conducted to investigate the relationship between the external variables and intention.
Results
Direct subjective norms, direct perceived behavioural control (PBC), and indirect measures of attitude predicted the intention to examine patients. Negative attitudes toward examining women had a suppressor effect on the prediction of health workers’ intentions. However, the main predictors with the highest coefficients were the external variables being a nurse as opposed to a clinical officer and workload of attending 20–50 patients per day. In bivariate analysis with intention to perform a gynaecological examination, there was no evidence that working experience, being female, having a lower workload, or being a private practitioner were associated with a higher intention to conduct vaginal examinations. Clinical officers and nurses were equally likely to examine women.
Conclusions
The TPB is a suitable theoretical basis to predict the intention to perform a gynaecological examination. Overall, the model predicted 47% of the variation in health care providers’ intention to examine women who present with recurrent vaginal bleeding or discharge. Direct subjective norms (health provider’s conformity with what their colleagues do or expect them to do), PBC (providers need to feel competent and confident in performing examinations in women), and negative attitudes toward conducting vaginal examination accounted for the most variance. External variables in this study also contributed to the overall variance. As the model in this study could not explain 53% of the variance, investigating other external variables that influence the intention to examine women should be undertaken.
Cognitive Visual Dysfunctions in Children with Autism Spectrum Disorders and Other Developmental Delays
Authors: Seo Jin Kyung , Kim Young Hoon , Park Eu Gene
Published: July 2020

Background: Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders characterized by a triad of social, communicative, and imaginative impairments. Although early detection and intervention are important to improve functional outcomes in ASD, similar features between ASD and other developmental delays may impede timely diagnosis. In this study, we aimed to investigate the feasibility of Cognitive Visual Assessment Questionnaire (CVAQ) in differentiating ASD from other developmental delays.Methods: We retrospectively reviewed the medical records of 115 pediatric patients (80 males, 35 females) with ASD and other developmental delays who had the Modified Checklist for Autism in Toddlers (M-CHAT) and CVAQ performed at Uijeongbu St. Mary's Hospital from January 2017 to June 2019. Results: The mean age at M-CHAT and CVAQ was 31.8 months (range, 14.1 – 48). The proportion of ASD was significantly higher in patients with screen-positive M-CHAT than those with screen-negative M-CHAT (P = 0.035). The sensitivity of CVAQ for detecting ASD was 83.3% and 94.1% in 14.1 – <24 months and 24 – <36 months age groups, respectively. Among patients with screen-negative M-CHAT, the mean number of failed tasks related to dorsal stream pathway was greater in ASD compared to other developmental delays, although the differences were not statistically significant (P = 0.437).Conclusions: Our study demonstrates that autistic individuals may have a specific impairment in dorsal stream functioning. CVAQ also showed improved sensitivity for detecting ASD in toddlers. When coupled with clinical observation and judgement, CVAQ is a useful alternative screening tool for differentiating ASD from other developmental delays in young children.
Transcriptome Analysis and Differential Gene Expression Profiling of Two Contrasting Quinoa Genotypes in Response to Salt Stress
Authors: Shi Pibiao , Gu Minfeng
Published: July 2020

Background: Soil salinity is one of the major abiotic stress factors that affect crop growth and yield, which seriously restricts the sustainable development of agriculture. Quinoa is considered as one of the most promising crops in the future for its high nutrition value and strong adaptability to extreme weather and soil conditions. However, the molecular mechanisms underlying the adaptive response to salinity stress of quinoa remain poorly understood. To identify candidate genes related to salt tolerance, we performed reference-guided assembly and compared the gene expression in roots treated with 300 mM NaCl for 0, 0.5, 2, and 24 h of two contrasting quinoa genotypes differing in salt tolerance.Results: The salt-tolerant (ST) genotype displayed higher seed germination rate and plant survival rate, and stronger seedling growth potential as well than the salt-sensitive (SS) genotype under salt stress. An average of 38,510,203 high-quality clean reads were generated. Significant Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were identified to deeper understand the differential response. Transcriptome analysis indicated that salt-responsive genes in quinoa were mainly related to biosynthesis of secondary metabolites, alpha-Linolenic acid metabolism, plant hormone signal transduction, and metabolic pathways. Moreover, several pathways were significantly enriched amongst the differentially expressed genes (DEGs) in ST genotypes, such as phenylpropanoid biosynthesis, plant-pathogen interaction, isoquinoline alkaloid biosynthesis, and tyrosine metabolism. 117 DEGs were common to various stages of both genotypes, identified as core salt-responsive genes, including some transcription factor members, like MYB, WRKY and NAC, and some plant hormone signal transduction related genes, like PYL, PP2C and TIFY10A, which play an important role in the adaptation to salt conditions of this species. The expression patterns of 21 DEGs were detected by quantitative real-time PCR (qRT-PCR) and confirmed the reliability of the RNA-Seq results. Conclusions: We identified candidate genes involved in salt tolerance in quinoa, as well as some DEGs exclusively expressed in ST genotype. The DEGs common to both genotypes under salt stress may be the key genes for quinoa to adapt to salinity environment. These candidate genes regulate salt tolerance primarily by participating in reactive oxygen species (ROS) scavenging system, protein kinases biosynthesis, plant hormone signal transduction and other important biological processes. These findings provide theoretical basis for further understanding the regulation mechanism underlying salt tolerance network of quinoa, as well establish foundation for improving its tolerance to salinity in future breeding programs.
The Mental Health Crises of the Families of COVID-19 Victims: A Qualitative Study
Authors: mohammadi fateme , Oshvandi Khodayar , Shamsaei Farshid , Cheraghi Fateme , bijani mostafa
Published: July 2020

Background: The bereaved families of COVID-19 victims are among the most vulnerable social groups in the COVID-19 pandemic. This highly infectious and contagious disease has afflicted these families with numerous psychological crises which have not been studied much yet. The present study is an attempt at investigating the psychological challenges and issues which the families of COVID-19 victims are faced with. The present study aims to identify the Mental Health crises which the families of COVID-19 deceased victims are going through.Methods: A qualitative research, the present study uses a conventional content analysis design. The participants were 16 members of the families of COVID-19 victims selected from medical centers in Iran from February to May 2020 via purposeful sampling. Sampling continued to the point of data saturation Data were collected via semi-structured individual interviews conducted online. The collected data were analyzed according to the conventional qualitative content analysis approach.Results: Analyses of the data yielded two main themes—emotional shock and fear of the future—with nine categories. Conclusion: The families of COVID-19 deceased victims are affected by various psychological crises which have exposed them to a deep sense of loss and emotional shock. In addition, the instability in the family following the loss of a family member and job insecurity due to the COVID crisis have caused them to be very worried about the future. Therefore, there is an urgent need for a cultural context which recognizes and supports all the various aspects of the mental health of these families.
Estimating Clinical Burden and Valuation of Weight Management Strategies (using Willingness to Pay - WTP) for Overweight and Obesity in Primary Care Setting in Borneo Sarawak, Malaysia
Authors: Ahmed Zafar , Bari Euphrasia Anak , Ahmed Noormah Z , Puteh Sharifa Ezat Wan
Published: July 2020

Background

Overweight and obesity is one of the most serious public health challenges of the 21st century. Despite the consequences of obesity, participation in weight management programs. Aim of this study is to estimate the clinical burden of obese patients in government primary care clinics in Kuching, Sarawak. We use randomized patients from these clinics to carry out a willingness to pay study for weight management and estimated the economic burden of overweight and obesity management in primary care setting in Sarawak. Identifying their willingness to pay will help in formulation and implementation of policies for effective weight management therefore improve the quality of care in future. Clinic based cross-sectional study involving 252 randomly overweight and obese patients (with BMI ≥ 23), age 18 to 59 years old, who attended outpatient department.
Results

Patients indicated their preference for three hypothetical weight reduction programs: diet, exercise, drug and combination of all. Data from secondary sources was used to estimate the prevalence of overweight and obesity in Sarawak. Out of 1,504,779 patients aged 18 to 59 years attending government health clinics in Sarawak, it was estimated that overweight and obesity would account for approximately 30% of total adult patients (451,433 patients). Conversion to USD was based on December 2015 conversion rate of USD 100 to MYR 430.31. The median willingness to pay was MYR 44.87 (USD 11.56), MYR 88.80 (USD 21.01), and MYR 60.18 (USD14.24) for Drug and Exercise, Diet and Exercise and Drug, Diet and Exercise respectively.
Conclusion

Resource allocation for weight management intervention in Sarawak, Malaysia depend on evaluation of weight management intervention (objectively measured by WTP) and the availability of fixed budget from State Health Department. The total WTP for weight reduction intervention via diet and exercise was MYR 22, 512, 963.71 (USD 5,231,801.19), while weight reduction intervention via drug, diet and exercise was MYR of 40, 087, 250.40 (USD 9,315,900.30 ) and weight reduction intervention via drug and exercise was MYR 27, 167, 237.94 (USD 6,313,410.78). Clinical and economic burden of overweight and obesity in Sarawak is substantial. Therefore implementation of effective policies and programs are essential in tackling obesity.
Melatonin Enhanced Short-term Salt Tolerance Through Improving Water Status in Maize Seedlings 
Authors: Zhang Ningning , Yan Jiakun , Li Meng
Published: July 2020

Background: The beneficial effects of melatonin (MT) on enhancing plant salt stress tolerance has been widely studied. However, the underlying mechanism that involved in MT-mediated the detailed process of plant water uptake and transport under salt stress condition remains largely unknown. To detect the underlying mechanisms that exogenous melatonin application enhances plant salt resistance, the influence of MT (1 μM) on maize (Zea mays L.) seedlings growth under short-term salt stress (2h, 100 mM NaCl) was investigated. Result: Results showed exogenous MT had increased the endogenous MT content in maize root. Under normal condition exogenous MT application did not affected the growth of seedlings significantly, whereas under salt stress condition MT application produced 99% in root and 20.2% in biomass higher than that without MT. Salt stress decreased the leaf net photosynthetic rate, leaf stomatal conductance, leaf transpiration rate, root hydraulic conductance and whole plant hydraulic conductance (Lp) significantly, but exogenous application of MT mitigated these salt stress-induced decreases. Plants treated with MT held higher photosynthetic rate (24.3%), stomatal conductance (39.4%), and transpiration rate (40.7%) compared with untreated plants under salt stress. Compared with normal condition, salt decreased Lp by only 61% in melatonin-treated seedlings and decreased by 97% in untreated seedlings. RT-PCR and the aquaporin inhibitor mercury were used to detect role of aquaporin in this process. Under salt stress, melatonin increased specific aquaporin gene (ZmPIP1;6, ZmPIP2;3 and ZmPIP2;7) expression, and under HgCl2 treatment, there was no significant difference in transpiration rates of seedlings with and without MT, which confirmed that the aquaporin played an important role in exogenous MT-induced improved maize root water uptake capacity under salt stress.Conclusions: Taking all these results into consideration, this study indicates that exogenous melatonin pre-treatment enhances maize resistance to short-term salt stress by regulating Lp through improving expression and activity of root aquaporin.
Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care
Authors: Muñoz Ricard Carrillo , Moreno Jose Luis Ballve , Balboa Ivan Villar , Matos Yolanda Rando , Puertolas Oriol Cunillera , Perez Estrella Rodero , Curto Xavier Monteverde , Ripollès Carles Rubio , Farres Noemi Moreno , Agudelo Olga Lucia Arias , Ortega Jesus Almeda
Published: July 2020

Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513
Effects of Corn Steep Liquor on ß-poly(L-malic Acid) Production in Aureobasidium Melanogenum
Authors: Wang Genan , Zhang Pan , Shi Bingyi , Zhao Tingbin , Yin Haisong , Qiao Changsheng
Published: July 2020

ß-poly(L-malic acid) (PMLA) is a water-soluble biopolymer used in medicine and other industries. However, the concentration of PMLA produced by microorganisms was too low for large-scale production. In this experiment, corn steep liquor (CSL) was selected due to its high nutritional value and low-cost growth factor to increase the production capacity of PMLA in the strain Aureobasidium melanogenum, and the strain’s CSL-influenced metabolic change was investigated. The PMLA production, cell growth, and yield (Yp/x) of A. melanogenum increased by 32.76%, 41.82%, and 47.43%, respectively, with the addition of 3 g/L CSL. Metabolomics analysis showed that the intracellular metabolites of A. melanogenum, such as amino acids, organic acids, and key intermediates in the TCA cycle, increased after the addition of CSL. Meanwhile, the data found that tyrosine may play a key role in the PMLA biosynthesis. These results demonstrated that the addition of CSL is an efficient approach for improving the production of PMLA.
Dependency and Vulnerability of Intensive Care Medicine in Times of COVID-19 Crisis
Authors: Lingitz Marie-Therese , Roth Georg A. , Krenn Claus G.
Published: July 2020

Background. Since December 2019, Coronavirus Disease-2019 (COVID-19) spread rapidly all over the world, resulting in pandemic. Through high hospitalization rates and via potentially exponential expansion of the disease, the COVID-19 crisis places a tremendous strain on healthcare systems, especially on limited numbers of hospital and Intensive Care Unit (ICU) – beds and equipment.Methods. The aim of this study was to elucidate the possible dependency of ICUs in European Countries with Austria as a pars pro toto in particular on long transglobal supply chains and its potential vulnerability by reported shortages of essential medicines and limited capacities in times of globalization and asserted economic advantages versus the pandemic threat of COVID-19. From 3 April to 8 April 2020 we performed a short survey with heads of Austria’s ICU-wards in different institutions following a structured questionnaire to enquire their personal experience and assessment.Results. We surveyed nearly half of the head physicians of ICUs (n=40) in Austria. 55 percent (n=22) are already treating COVID-19 affected patients at their ICU department. Only 45 percent (n=18) of them had received the amount of personal protective equipment they deemed enough, and 90 percent (n=36) of surveyed ICUs were already informed about shortage supplies concerning personal protective equipment. 45 percent (n=18) already reported infections within their medical personnel. 35 percent (n=14) already reported supply difficulties in several pharmaceuticals, whereas 73 percent (n=29) were informed or already warned by their economic or purchase departments about further potential or real shortages concerning essential pharmaceuticals in near future. Conclusions. Summarizing the results of our survey we would like to draw attention to the lessons we can learn from the COVID-19 crisis in the European Union: European Countries with Austria as a pars pro toto should establish a national production of key equipment and disposables ,at least a minor part of personal protective equipment as well as key pharmaceuticals. European countries need to improve far distance supplies and invest in maintaining critical infrastructure especially in those with limited capacities such as health care in general and ICUs in particular.
Tissue-specific 5-hydroxymethylcytosine landscape of the human genome
Authors: He Bo , Zhang Chao , Zhang Xiaoxue , Fan Yu , Zeng Hu , Liu Jun'e , Meng Haowei , Bai Dongsheng , Peng Jinying , Zhang Qian , Tao Wei , Yi Chengqi
Published: July 2020

5-Hydroxymethylcytosine (5hmC) is an important epigenetic mark that regulates gene expression. Charting the landscape of 5hmC in human tissues is fundamental to understand its regulatory functions. Here, we systematically profiled the whole-genome 5hmC landscape at single-base resolution for 19 types of human tissues. We found that 5hmC preferentially decorates gene bodies and outperforms gene body 5mC in reflecting gene expression. Approximately one-third of 5hmC peaks are tissue-specific differentially hydroxymethylated regions (tsDhMRs), which are deposited in regulatory elements that regulate the expression of nearby tissue-specific functional genes. In addition, tsDhMRs are enriched with tissue-specific transcription-factor-binding sites and may rewire tissue-specific gene expression networks. Moreover, tsDhMRs are associated with SNPs identified by genome-wide association study (GWAS), linked to tissue-specific phenotypes and diseases. Collectively, our results show the tissue-specific 5hmC landscape of the human genome and demonstrate that 5hmC serves as a fundamental regulatory element affecting tissue-specific development and diseases.
In Vitro Propagation via Organogenesis and Formation of Globular Bodies of Salvia Plebeia: A Valuable Medicinal Plant
Authors: Wu Qinggui , Yang Honglin , Sun Yuxi , Hu Jinyao , Zou Lijuan
Published: July 2020

Background: As a highly valued medicinal plant, Salvia plebeia R. Brown belongs to the Lamiaceae family that has been subjected to over exploitation in its natural habitat for phytochemical and pharmacological studies. Alternative collection methods need to be developed for the large-scale propagation of Salvia plebeian. Results: Here, efficient and simple, direct organogenesis (from shoot tips and cotyledonary nodes explants) and Globular bodies (GBs) induction (from hypocotyl explants) systems were developed for the in vitro propagation of Salvia plebeia. The highest and number of regenerated shoots (7.0±0.82) per shoot tips was obtained on Murashige and Skoog (MS) medium supplemented with a combination of 0.1 mg L-1 indole-3-acetic acid (IAA) and 1.0 mg L-1 6-benzyladenine (6-BA), the proliferation of shoots and shoots rooted were carried out on the same medium treatments almost synchronously. Similarly, MS medium supplemented with 0.1 mg L-1 IAA and 1.0 mg L-1 thidiazuron (TDZ) yielded the maximum number of shoots (37.5±1.34) with 100% shoot sprouting frequency. Simultaneously, a protocol was developed for GBs induction from hypocotyl explants, and it produced 17.4 GBs per explant with 82.7% response on MS medium supplemented with TDZ (1.0 mg L-1) and IAA (0.1 mg L-1), and produced GBs that were morphologically similar to globular embryos and successfully germinated on hormone-free MS medium. The acclimatized plantlets with well-developed root systems were successfully shifted to the natural soils with a 100% survival rate. Conclusions: Taken together, this protocol can be efficiently used for mass propagation, germplasm preservation and likely also for gene transfer of Salvia plebeia.
Time allocation to active daily domains, physical activity, and health indicators in older adults: Cross-sectional results from the OUTDOOR ACTIVE study.
Authors: Stalling Imke , Albrecht Birte Marie , Doerwald Friederike , Bammann Karin
Published: July 2020

Background
Physical activity (PA) is one of the key determinants of healthy ageing. Research showed that time allocation plays an important role in PA. Therefore, an understanding of the time use of older adults is crucial for developing PA programs. The aim of this study was to examine the associations of time allocation and objectively measured PA, and several health indicators in older adults.
Methods
In this cross-sectional study all 915 participants of the OUTDOOR ACTIVE study were included. The participants were 65 to 75 years old and resided in a subdistrict of Bremen, Germany (50.9% female). The active daily domains were derived from the SLOTH model (leisure activities, occupation, active transport, home-based activities). PA was objectively measured with accelerometers over seven consecutive days. Binary logistic regressions were used to test the associations of total PA and time spent in the domains with several health indicators (self-rated health, overweight, obesity, activities of daily living (ADL), handgrip strength).
Results
Participants over the age of 70 years were significantly less physically active than those under 70 years and women were significantly more physically active than men. Regardless of age and sex, most time was spent on home-based activities (women: 118.5 ± 87.8 min/day; men: 80.2 ± 69.4 min/day). Both PA and time spent on leisure activities were associated with a lower risk of bad self-rated health (0.36; 95%-CL: 0.20, 0.65 for PA; 0.93; 95%-CL: 0.87, 0.99 for leisure activities) and less limitations in ADL. PA and active transport seemed to lower the risk of overweight (0.39; 95%-CL: 0.25, 0.62 for PA; 0.80; 95%-CL: 0.69, 0.93 for active transport) and obesity (0.36; 95%-CL: 0.21, 0.60 for PA; 0.77; 95%-CL: 0.64, 0.92 for active transport). Having an occupation was associated with a lower risk of bad self-rated health (0.60; 95%-CL: 0.40, 0.92).
Conclusions
The results of this study provide insights in the time allocation to active daily domains and total PA of older adults, as well as the associations with health indicators. These findings have important implications for the development of PA programs. Future research should examine the associations further in longitudinal studies.
Epidemiological features and hotspot of COVID-19 in Isfahan province of Iran: Results of a cohort study
Authors: Janani Majid , Beheshti-Nia Fereshte , Ahmadi Hamzeh , Khazeni Atefeh , Yadegarfar Ghasem
Published: July 2020

Background and Aim: The aim of this study was to description of the epidemiological features and hotspot of COVID-19 in Isfahan province of Iran.Method: In this descriptive, retrospective cohort, multicenter study, all patients admitted to one of the hospitals or health networks of Isfahan province from 3rd February to 13th June 2020 due to RT-PCR (Reverse transcription-polymerase chain reaction) test were enrolled to study. Trained staff followed up participants for two weeks by a Telephone number, and the outcome was recorded.Result: Up to 13 June, 41,498 patients recruited and their data were analyzed; the incidence of COVID-19 was 27.5% (95% CI: 27.1, 28.2). Among the participants with the positive test, 93.2% of them, treated by outpatient basis or discharged, 2.1% were hospitalized, and the case fatality rate (CFR) was 4.8%. Khansar and Aradestan was the hotspot of COVID-19 and had the highest incidence among cities of Isfahan province. Najafabad, Khomeinishahr, and Shahinshahr&Meymeh had the highest imported cases of COVID-19 to the capital of Isfahan province, Isfahan city. Also, Charmahal & Bakhtiari, Khuzestan, and Fars provinces had the highest number of imported cases from other provinces to Isfahan city. We found that 77.3% of intra-province imported cases and about 83% of inter-province cases were imported after reducing lockdown.conclusion: The incidence and fatality of COVID-19 in Isfahan province is alarming. Inter-city and inter-provincial unnecessary travels have a high impact on the transmission and spread of the COVID-19. Applying more restrictions will prevent this from happening. It is advised to restrict the inter cities travels again by policy makers for the benefit of public health.
Exosomes synthesizing HER2 miRNA and engineered to adhere to HER2 on surface tumor cells exhibit enhanced anti-tumor activity
Authors: Wang Lei , Zhou Xusha , Zou Weixuan , Wu Yinglin , Zhao Jing , Chen Xiaoqing , Zhou Grace Guoying
Published: July 2020

Introduction: Exosomes are small vesicles derived from cellular membranes with a diameter of 50–150 nm. Exosomes are considered to be ideal drug delivery systems with a wide range of application in various diseases including cancer. However, nonspecific delivery of therapeutic agents by exosomes in vivo remains a challenging. Human epidermal growth factor receptor 2 (HER2) is an epidermal growth factor receptor tyrosine kinase. Overexpression of HER2 is usually associated with cancer survival and progression in various cancers. In this study, we aimed to develop the novel exosomes with dual HER2-targeting ability as nanoparticle delivery vehicle to enhance anti-tumor efficacy in vivo.Results Here we report the construction of two kinds of exosomes carrying designed miRNA to block the synthesis of HER2 and as a consequence to kill the tumor cells. The 293-miR-HER2 exosomes package and deliver designed miRNA to cells to block HER2 synthesis. These exosomes kill cancer cells dependent on HER2 for survival but have no effect on cells lacking of HER2 or which were engineered to express HER2 but do not depend on it for survival. The 293-miR-XS-HER2 exosomes carry one more peptide, which enables the exosome to adhere HER2 on the surface of the cancer cells. In consequence these exosomes preferentially enter and kill cells exhibiting HER2 on their surface. The 293-miR-XS-HER2 exosomes are significantly more effective in shrinking the size of HER2-positive tumors implanted in mice than the 293-miR-HER2 exosomes.Conclusion Collectively, as novel anti-tumor drug delivery vehicles, the HER2 dual-targeting exosomes has increased target-specific delivery efficiency, which can be further utilized to develop new nanoparticle targeted therapy.
Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea
Authors: Kidanemariam Betiel Yihdego , Elsholz Traudl , Simel Laban L. , Tesfamariam Eyasu H. , Andemeskel Yonatan M.
Published: July 2020

Background
Postoperative pain remains a concern to both patients and health care professionals. Non-pharmacological pain relief methods have the potential to complement pharmacological interventions and may offer alternative treatment options. The aim of the study was to assess nurses’ utilization of postoperative nurses’ non-pharmacological pain relief methods and the perceived barriers for their implementation in the National Hospitals.
Methods
Descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation of those methods were used to collect data. Descriptive statistics for the demographic data, independent samples t-test and one way ANOVA for the nurses’ utilization of the non-pharmacological methods and perceived barriers were used to analyze the data. Statistical significance level was set at P < 0.05.
Results
The study found that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were reported to be the most frequently used methods, whereas the cognitive-behavioral (5.9%) and physical methods (5.8%) were found with less frequency. The results also show that characteristics, such as the nurses' age (p = 0.013), education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods. Among the various perceived barriers, health care system related barriers such as heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), lack of administrative support (76.6%) followed by patient related barriers such as patients uncooperative behavior (57.1%) were identified.
Conclusion
Only few of the non-pharmacological methods were found to be utilized by the nurses as pain relieving strategies and various perceived barriers are existing among the nurses towards the utilization of these methods. Nurses in these settings need training and education on non-pharmacological pain relief methods, particularly on methods that are utilized less often.
How well are general practitioners informed about chronic kidney disease?
Authors: Haddiya Intissar , Elgharab Jalal , Bentata Yassamine
Published: July 2020

Background In most health systems, general practitioners (GPs) are the frontline caregivers. They, thus, should have the appropriate knowledge in order to detect, manage and refer patients to the specialist at the right time. In the context of Chronic kidney disease (CKD), a major public health issue, they have an important role to play in the care process. The purpose of this paper was to evaluate their CKD related knowledge.Methods We have performed a Cross-sectional survey, in the last trimester of 2019, that had included GPs practicing in Eastern morocco, using a Googleform questionnaire, based on the KDIGO 2012 guidelines.Results Our respondents’ mean age was 42.4 ± 11.26 years old. 59% of them were women. Mean seniority in general practice was 14.3 ± 9.9 years. 64.47% worked in the public sector. 52.63% of GPs had insufficient CKD related knowledge. Less than half of the physicians could select the correct definition of CKD and only 29.61% knew that it is classified into five stages. Other than diabetes and high blood pressure, other CKD risk factors were identified by 38.15% of GPs. In addition, only 39.4% of the participants knew about peritoneal dialysis.Conclusion Our study concluded to GPs’ lack of CKD related knowledge. The continuing medical education of these frontline practitioners is mandatory in order to ameliorate patients management.
Fabrication of Al2O3-coated BiFeO3 particles and fine-grained ceramics with improved electric properties
Authors: Bai Peijia , Li Yutong , Wang Gang , Han Jiao , Wei Yongxing , Li Mingwei , Mao Duan , Zeng Yiming
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
An assessment of the livelihood vulnerability of climate induced migrants: A case study on Sagar Island, India
Authors: Bera Aparna , Singh Suraj Kumar
Published: July 2020

The effects of climate change are causing large scale human displacements all over the World over past few decades and climate refugees are putting biggest challenges to the geophysical biological and social system. This paper attempts to assess the vulnerability of both the refugee and regular settlers of selected mouzas of Sagar Island, south 24parganas, India where people are witnessing their lands vanishing under their feet in these constantly sinking and shrinking deltaic estuaries. Findings of LVI and LVI-IPCC analysis indicate that the climate induced migrant communities are more exposed to climatic variability due to poor adaptive capacity. Poor access to food, water, health facilities are making them extremely vulnerable with lower resilience as these mouzas are facing frequent flooding, severe coastal erosion, embankment breaching and higher storm surges on an annual basis. The outcomes of this study could be beneficial for effective on site risk management, adaptation strategies and further planning propositions.
Prevalence of Physical Inactivity and Sedentary Behaviors and Associations with Obesity among Saudi Adults
Authors: Althumiri Nora A , BinDhim Nasser F , Alqahtani4 Saleh A.
Published: July 2020

Background: Worldwide, physical inactivity is ranked as the fourth leading risk factor for mortality. This study aimed to provide an update on the prevalence of physical inactivity and sedentary behavior among adults in Saudi Arabia and to examine associations with obesity.Methods: This study was conducted as secondary analysis of a national survey that was conducted in Saudi Arabia in 2018. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Participants (n = 3,699) were recruited mainly via random phone interviews. The World Health Organization (WHO) recommendations (150 minutes of moderate activity/week or 75 minutes of intensive activity/week) were used to classify physical activity. Logistic regression was used for multivariate analysis.Results: The prevalence of physical inactivity (not meeting the WHO recommendations) ranged between 66.8% and 81.2%. Females and males did not differ in their frequency of physical activity. Participants spent an average of 275 minutes/day watching TV or using phone apps and 267 minutes/day doing office work. Physical inactivity was associated with increased likelihood of obesity (BMI ≥ 30), as compared to those who met the WHO intensive physical activity criteria (odds ratio [OR]: 1.62; 95% CI: 1.23–2.13) and to those who met WHO mixed intensive/moderate physical activity criteria (OR: 1.49; 95% CI: 1.24–1.81), adjusted for age and gender. However, sitting long hours for work or leisure was not significantly associated with obesity.Conclusions: Future research is needed to identify public health interventions that would be most feasible and suitable for physical inactivity and sedentary behavior reduction at the national level for national implementation; and health policies are needed to facilitate sustainability.
Analysis of the mountain sickness of tourists in China from 2015-2017
Authors: Li Xiang , Xie Chaowu
Published: July 2020

Background: Mountain sickness significantly affects tourists who travel in plateau areas. Most studies have researched patients, climbers and local residents to analyse the identification, causes, symptoms and effects of mountain sickness, and only a few have assessed tourists.Methods: This study used the Jiangtai Insurance Broker, an exemplary underwriting platform for travel agency liability insurance in China, as the data acquisition platform to analyse tourist altitude sickness from an epidemiological perspective. The chi-square test was used to test the distribution of mountain sickness diseases and symptoms among different genders and ages. A geographic information system (GIS) was used to generate a spatial distribution map of tourist mountain sickness.Results: From 2015 to 2017, there were 361 cases of tourist mountain sickness, which were distributed in 4 altitudinal classes. The incidence of mountain sickness was higher in women than in men. Tourists aged 40-69 years were the main group of patients. Acute mountain sickness (AMS) and high-altitude pulmonary edema (HAPE) were the main high-altitude diseases and mainly occurred in the 2nd and 3rd class altitude regions. Hypoxia, dizziness, headache and chest tightness were the main symptoms of mountain sickness. Spring, summer and autumn were the peak seasons for the onset of mountain sickness. Mountain sickness cases were concentrated in a few cities in Western China.Conclusion: This study analysed the genders and characteristics of the main tourist population that suffered from mountain sickness and investigated the diseases and the temporal and spatial regularity of disease from an epidemiological perspective. The research showed that the onset of mountain sickness was related to the individual physique and age of tourists, speed of entering the plateau, season and altitude. This study is significant as a reference for the risk assessment of tourists visiting plateau areas.