bluuebunny/crossref_metadata_2025 huggingface dataset:
Paisaje de sal de mar en Chile. Desastre y Resiliencia. Breve reseña de la huella de algunos terremotos-tsunamis en las salinas costeras = Landscape of sea salt in Chile. Disaster and Resilience. Brief overview of the footprint of some earthquakes- tsunamis in coastal salt flats
Authors: Orozco Salinas Karina
Published: May 2020

RESUMEN:La presente investigación se enfoca en el paisaje de sal de mar en Chile en el contexto de desastres, tomando como estudio de caso algunos de los terremotos- tsunamis y su huella en las salinas costeras, a fin de observar la resiliencia de estospaisajes.La metodología se ha desarrollado en tres fases y ha consistido en un estudio descriptivo, mediante una recopilación y revisión bibliográfica de fuentes primarias y secundarias online, que permitieron identificar como casos de estudio los terremotos-tsunamis de 1730,1751, 1906, 1960 y 2010 y, las afectaciones en algunas de las salinas litorales.Los resultados arrojaron que hay salinas que han tenido una respuesta resiliente ante los efectos de al menos 6 terremotos-tsunamis en un periodo de 280 años. En definitiva, los paisajes de sal de mar activos en Chile conllevan la incertidumbre latente en ellos, en donde los eventos catastróficos han puesto a prueba su capacidad de adaptación, resiliencia y su memoria colectiva  para poder sobreponerse al desastre. De esta forma albergan la huella e internalizan la recurrencia de fenómenos que, aunque no son inusuales, son imprevisibles en elterritorio. ABSTRACT:The present investigation focuses on the sea salt landscape in Chile in the context of disasters, taking as a case study some of the earthquakes-tsunamis and their footprint on the coastal salt flats, in order to observe the resilience of theselandscapes.The methodology has been developed in three phases and has consisted of a descriptive study, through a collection and bibliographic review of primary and secondary sources online, that allowed to identify as case studies the earthquakes-Tsunamis of 1730, 1751, 1906, 1960 and 2010 and, the effects on some of the salines.The results showed that there are salines that have had a resilient response to the effects of at least 6 earthquakes-tsunamis over a period of 280 years. In short, the active sea salt landscapes in Chile carry the uncertainty inherent in them, where catastrophic events have tested their capacity to adapt, resilience and collective memory to overcome the disaster. In this way, they house the footprint and internalize the recurrence of phenomena that, although not unusual, are unpredictable in theterritory.
Sejarah Penyebaran Islam di Konfederasi Turatea Abad XVII (Tinjauan Sistem Pemerintahan dan Religi)
Authors: Rahman Eka Yuliana
Published: May 2020

This study aims to examine the history of Islamization in the Turatea Confederation,  a review of the government and religious systems, especially in the XIII Century. This research is based on a note from Christian Pelras, Anthropologist of the Bugis-Makassar, said that before the Gowa-Tallo kingdom made Islam a royal religion, the ruler (aristocrats) and the people of the Turatea Confederation had embraced Islam through the practice of power relations between the kingdom, religious leaders and the people . This study uses qualitative methods to find and describe in analysis and interpret the socio-cultural conditions of the people in the Turatea Confederation before and after Islam. The results show that the pattern of power distribution centered on figures as local authorities is the most effective means of spreading religious teachings. The development of Islamic religious symbols changed the system of government and belief by strengthening the Islamic tradition in the Turatea Confederation.

 

Tulisan ini bertujuan untuk menelaah sejarah Islamisasi di Konfederasi Turatea dalam tinjuan sistem pemerintahan dan religi khususnya pada Abad XIII. Riset ini didasari oleh adanya catatan dari Christian Pelras, Antropolog kajian kebudayaan Bugis-Makassar menyebutkan, sebelum kerajaan Gowa-Tallo menjadikan Islam agama kerajaan, penguasa (bangsawan) dan rakyat Konfederasi Turatea telah menganut Islam melalui praktik relasi kekuasaan antara kerajaan, tokoh agama dan rakyat. Riset ini menggunakan metode kualitatif untuk menemukan dan mendeskripsikan secara analisis serta menginterpretasikan kondisi sosial budaya masyarakat di Konfederasi Turatea sebelum dan sesudah Islam. Hasilnya menunjukkan, pola distribusi kekuasaan yang berpusat pada figur sebagai penguasa lokal merupakan sarana paling ampuh menyebarkan ajaran agama. Perkembangan syiar agama Islam mengubah  sistem pemerintahan dan kepercayaan dengan makin menguatnya tradisi Islam di Konfederasi Turatea.
Cigarette Pack Prices and Sales Following Policy Changes in California, 2011–2018
Authors: Boettiger David C. , White Justin S.
Published: May 2020

Objectives. To estimate the combined effect of California’s Tobacco 21 law (enacted June 2016) and $2-per-pack cigarette excise tax increase (enacted April 2017) on cigarette prices and sales, compared with matched comparator states.

Methods. We used synthetic control methods to compare cigarette prices and sales after the policies were enacted, relative to what we would have expected without the policy reforms. To estimate the counterfactual, we matched pre-reform covariate and outcome trends between California and control states to construct a “synthetic” California.

Results. Compared with the synthetic control in 2018, cigarette prices in California were $1.89 higher ($7.86 vs $5.97; P < .001), and cigarette sales were 16.6% lower (19.9 vs 16.6 packs per capita; P < .001). This reduction in sales equates to 153.9 million fewer packs being sold between 2017 and 2018.

Conclusions. California’s new cigarette tax was largely passed on to consumers. The new cigarette tax, combined with the Tobacco 21 law, have contributed to a rapid and substantial reduction in cigarette consumption in California.
Leucine rich repeats and calponin homology domain containing 1 inhibits microglia-mediated neuroinflammation in a rat traumatic spinal cord injury model
Authors: Chen Wen-Kai , Feng Lin-Juan , Liu Qiao-Dan , Ke Qing-Feng , Cai Pei-Ya , Zhang Pei-Ru , Cai Li-Quan , Huang Nian-Lai , Lin Wen-Ping
Published: May 2020

Background Spinal cord injury (SCI) triggers the primary mechanical injury and secondary inflammation-mediated injury. Neuroinflammation-mediated insult causes secondary and extensive neurological damage after SCI. Microglia play a pivotal role in the initiation and progression of post-SCI neuroinflammation. Methods To elucidate the significance of LRCH1 to microglial functions, we applied lentivirus-induced LRCH1 knockdown in primary microglia culture, and tested the role of LRCH1 in microglia-mediated inflammatory reaction both in vitro and in a rat SCI model. Results We found that LRCH1 was down-regulated in microglia after traumatic SCI. LRCH1 knockdown increased the production of pro-inflammatory cytokines such as IL-1β, TNF-α, and IL-6 after in vitro priming with lipopolysaccharide and adenosine triphosphate. Furthermore, LRCH1 knockdown promoted the priming-induced microglial polarization towards the pro-inflammatory inducible nitric oxide synthase (iNOS)-expressing microglia. LRCH1 knockdown also enhanced microglia-mediated N27 neuron death after priming. Further analysis revealed that LRCH1 knockdown increased priming-induced activation of p38 mitogen-activated protein kinase (MAPK) and Erk1/2 signaling, which are crucial to the inflammatory response of microglia. When LRCH1-knockdown microglia were adoptively injected into rat spinal cords, they enhanced post-SCI production of pro-inflammatory cytokines, increased SCI-induced recruitment of leukocytes, aggravated SCI-induced tissue damage and neuronal death, and worsened the locomotor function. Conclusion Our study reveals for the first time that LRCH1 serves as a negative regulator of microglia-mediated neuroinflammation after SCI, and provides clues for developing novel therapeutic approaches against SCI.
Immediate effects on cervical mobility and spiratory flow, after bilateral manipulation of first rib, in non-specific chronic neck pain: study protocol for a randomized controlled trial
Authors: Gonzalez-Gerez Juan Jose , Utrera Carlos Bernal , Anarte Ernesto , Rodriguez-Blanco Cleofas
Published: May 2020

Background: Numerous publications have showed the biomechanical influence of thoracic spine on cervical spine. Recently, some authors have pointed out the role of other physiological systems in this relationship, what have been calle interdependence regional model. It has been studies that interventions applied over thoracic spine have a neurophysiological influence on cervical spine and respiratory system. Our study evaluates the influence of bilateral manipulative technique of first rib on pain and pulmonary function in subjects with chronic non-specific neck pain. Methods: The immediate changes produced by bilateral direct manipulation (HVLA) of first rib in subjects with non-specific chronic neck pain will be studied. The sample will be randomly divided into two groups, experimental and placebo. As dependent variables of the study, we will measure the peak expiratory flow and cervical rom. Findings will be analyzed statistically considering a 5% significance level (p ≤ 0.05) Discussion: Our study aims to provide knowledge about the influence of bilateral manipulative technique of first rib in pain and pulmonary capacity in subjects with non-specific chronic neck pain. The efficacy of this technique may entail an easy access and low cost strategy in patients with pain and a reduction in pulmonary function. Trial registration Brazilian Clinical Trial Registry, RBR-4dsvfy. Registered on 17 March 2020. Retrospectively registered
Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients
Authors: Wang Qi , Zhao Hong , Liu Ligai , Wang Yanbin , Zhang Ting , Li Minghui , Xu Yanli , Gao Guiju , Xiong Haofeng , Fan Ying , Cao Ying , Ding Rui , Wang Jingjing , Cheng Cheng , Xie Wen
Published: May 2020

【Background】Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.【Methods】 This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild and severe groups. We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.【Results】 56.2% of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% cases the level of ALT, AST or TBil ≤ 3 fold of the upper normal range. The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (p<0.05).The percentage of the patients with both elevated ALT and AST was 12.7% in mild cases vs. 46.2% in severe cases (p = 0.001). 34.6% severe group patients started to have abnormal ALT after admission，and 73.4% of all patients had normal ALT before discharge.【Conclusion】Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN，but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.
Quantitative susceptibility mapping of brain iron deposition in patients with type 2 diabetes mellitus
Authors: Li Jing , Zhang Qihao , Zhang Nan , Guo Lingfei
Published: May 2020

Background Noninvasive quantitative susceptibility mapping (QSM) analysis was applied to assess brain iron deposition in the gray matter nucleus in type 2 diabetes mellitus (T2DM) patients and healthy elderly individuals.Methods Thirty-two T2DM patients and thirty-two age- and gender-matched healthy controls (HCs) were enrolled in this research. All participants underwent brain magnetic resonance examinations. Twenty-three DM patients and twenty-six healthy controls received cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to obtain magnitude and phase images; with preprocessed QSM data, ITK-SNAP helped to measure the susceptibility values reflecting the content of iron in the regions of interest (ROIs).Results The study included thirty-two T2DM patients (20 males and 12 females; mean age of 61.09 ± 9.99 years) and 32 HCs (14 males and 18 females; mean age of 59.09 ± 9.77 years). These participants were age- and gender-matched, with no significant difference (P > 0.05). T2DM patients exhibited an obviously (P < 0.05) lower MoCA score (26.78 ± 2.35; normal standard, ≥ 27) and higher SCWT score (157 (128,188); HC, 123 (112,152)) than HCs. The mean susceptibility values in the left putamen and right putamen as well as dentate nucleus in the left thalamus appeared obviously higher in T2DM patients than in HCs (P < 0.05). In all participants, the susceptibility values in the left dentate nucleus were significantly higher than those in the right side (P < 0.05). The susceptibility values and cognitive assessment scores showed no obvious association (P > 0.05). However, an obvious correlation exists between the changes in the susceptibility values across hemispheres in the dentate nucleus and the putamen (left, r = 0.439, P = 0.000; right, r = 0.260, P = 0.038).Conclusion T2DM patients showed increased iron deposition in the putamen, dentate nucleus and left thalamus. Cerebral iron deposition exacerbates cognitive decline in T2DM patients. Changes in susceptibility values in these regions are likely to be quantitative imaging markers of central nervous system injury in T2DM patients, and QSM may benefit their detection and evaluation.
Infant and young child feeding practices and nutritional status in two Health Zones of South Kivu, Eastern Democratic Republic of Congo: a community-based study.
Authors: Kambale Richard Mbusa , Ngaboyeka Gaylord Amani , Kasengi Joe Bwija , Niyitegeka Sarah , Cinkenye Boss Rutakaza , Baruti Armand , Mutuga Kizito Chentwali , Linden Dimitri Van der
Published: May 2020

Background In DRC, childhood undernutrition remains a serious public health concern. Internationally recommended infant and young child feeding (IYCF) practices may improve child nutritional status. This study aimed to describe IYCF practices, factors associated with inappropriate complementary feeding, and infant’s nutritional status.Methods A community-based cross-sectional study including 1,009 mother-infant pair was conducted in August 2019 in 32 health areas (16 in rural health zone and 16 in urban one) of South Kivu, Democratic Republic of Congo (DRC), among mothers who had infants under 24 months of age. Infant’s nutritional status was assessed using WHO Anthro plus software. To describe IYCF practices, we used the indicators recommended by the WHO. To study the factors associated with inappropriate complementary feeding practices, we performed univariable and multiple logistic regression analyzes. The data was analyzed in SPSS version 25.Results The prevalence of early initiation of breastfeeding and exclusive breastfeeding up to 6 months of age was 73.7% and 42.2% respectively. Of the 746 infants aged 6–23.9 months, 246 (32.3%) received appropriate complementary feeding. Of the 997 infants who had valid anthropometric parameters, 416 (41.7%) were well-nourished, 374 (37.5%) were undernourished and 207 (20.8%) were overweight. Multivariable logistic regression analysis revealed that residence in rural area [Adjusted Odds Ratio (AOR): 2.38 (95% Confidence Interval (CI): 1.49, 3.78)], non-attendance at postnatal care (AOR 1.63; 95% CI 1.12, 2.96), low household socioeconomic (AOR 1.72; 95% CI 1.14, 2.59) and low maternal education (AOR 1.83; 95% CI 1.20, 2.77) were factors associated with inappropriate complementary feeding. Mothers with inappropriate complementary feeding practices were 6.88 times more likely to have undernourished infants than their counterparts (AOR 6.88; 95% CI 1.24, 18.37).Conclusion Findings from this study provide strong evidence, both of association between inappropriate complementary feeding and undernutrition, and of the double burden of malnutrition with the co-existence of under- and overnutrition in the infant population in South Kivu. Interventions should focus on both preventing undernutrition and overweight to promote child well-being.
A new and spontaneous animal model for ankylosing spondylitis is found in cynomolgus monkeys
Authors: JIA Huanhuan , CHEN Meili , LUO Xiaoling , HOU Gang , LUO Ting , LIAO Jin’e , LI Yongfeng , CHEN Wei , CHEN Jun , LI Qingnan , MIU Kai Kei , Huang Ren , LU Li
Published: May 2020

Background
Ankylosing spondylitis (AS) is a progressive, disabling joint disease that affects millions worldwide. There is a lack of useful disease model to conduct comprehensive mechanistic studies. Non-human primate model is a potential spontaneous model for ankylosing spondylitis (AS).
Methods
A group of cynomolgus monkeys with abnormal joints and abnormal movements were screened out from about 20,000 cynomolgus monkeys primarily. A 2-years follow-up study of this group of cynomolgus monkeys having joint lesions reported of spinal stiffness was performed by conducting hematological testing, radiographic examination, family aggregation analysis, pathological analysis and genetic testing.
Results
These diseased animals suffered from spontaneous AS with clinical features recapitulating human AS disease progression. The spontaneous incidence rate and the onset age of AS in monkeys similar to epidemiological features of AS patients. The disease progression in disease monkeys have shown bone erosion, osteophyte formation and “Bamboo-like” change. ESR, CRP IL-17, TNF-α and VEGF levels significantly increase in AS monkeys comparing with normal monkeys. Several features similar to AS patients, including cartilage destruction, cartilage ossification, chondroid metaplasia and bone formation were shown in AS monkeys pathological examination results. Both the serum bone resorption and bone formation biomarkers of AS monkeys were significantly reduce. In our current SNP sequencing results, loci that similar to AS-relative SNPs in human genome have not yet been found.
Conclusions
The study offers a promising non-human primate model for spontaneous ankylosing spondylitis which may serve as an excellent substitute for its pre-clinical research.
Factors that discriminate invasive adenocarcinoma from minimally invasive adenocarcinoma and adenocarcinoma in situ in patients with pure ground-glass pulmonary nodules
Authors: Yang Huan-Huan , Lv Yi-Lv , Fan Xing-Hai , Ai Zhi-Yong , Xu Xiu-Chun , Ye Bo , Hu Ding-zhong
Published: May 2020

Purpose
The aim of the present study was to investigate predictors of pathological invasiveness and prognosis of lung adenocarcinoma in patients with pure ground-glass nodules (pGGNs).
Methods
Clinical and computed tomography (CT) features of invasive adenocarcinomas (IACs) and pre-IACs were retrospectively compared in 641 consecutive patients with pGGNs and confirmed lung adenocarcinomas who had been followed up by CT postoperatively, and potential predictors of prognosis were investigated.
Results
Of 659 pGGNs in 641 patients, 258 (39.1%) were adenocarcinomas in situ, 265 (40.2%) were minimally invasive adenocarcinomas, and 136 (20.6%) were IACs. Respective optimal cutoffs for age, serum carcinoembryonic antigen, maximal diameter, mean diameter, and CT density for distinguishing preIACs from IACs were 53 years, 2.19 ng/mL, 10.78 mm, 10.09 mm, and − 582.28 Hounsfield units (HU). In univariable analysis sex, age, maximal diameter, mean diameter, CT density, and spiculation were significant predictors of lung IAC. In multivariable analysis age, maximal diameter, and CT density were significant predictors of lung IAC. During a median follow-up of 41 months no pGGN IACs recurred.
Conclusions
pGGNs may be lung IACs, especially in patients aged > 55 years with lesions that are > 1 cm in diameter and exhibit CT density > − 600 HU. pGGN IACs of < 3 cm in diameter have good post-resection prognoses. These data may assist the selection of surgical procedures in patients with pGGNs at high risk of malignancy.
­Knowledge and behaviour about preconception care among women desiring conception, from tribal and non-tribal areas; a qualitative study using focused group discussions
Authors: Doke Prakash Prabhakarrao , Gothankar Jayashree Sachin , Patil Archana Vasantrao , Pore Prasad Dnyandeo , Palkar Sonali Hemant , Deshpande Aniruddh Vinayakrao , Karnataki Madhusudan Vamanrao , Bhuyan Khanindra Kumar , Shrotri Aparna Nishikant , Chutke Amruta Paresh
Published: May 2020

Background India has the highest number of under-five deaths in any country in the world. World Health Organization and Government of India recommended roll out of preconception care (PCC) for reduction of maternal and child mortality. However, very few countries including India have implemented a comprehensive package of PCC services. PCC has been rolled out among all women, who desire to be pregnant in one year through the government health system in two blocks of Nashik district of Maharashtra State, India. In order to assess the impact of PCC in these two blocks, baseline and post intervention studies (both quantitative and qualitative) on women’s knowledge and behaviour on PCC, their health status and pregnancy outcomes are planned in these two intervention blocks as well as in two control blocks. To assess women’s knowledge and behaviour on PCC before implementation of the project, focus group discussions (FGDs) were carried out as part of this impact assessment project.Methods From each of the four blocks, two villages having sub centre were selected for conducting FGD. A house to house survey was conducted by Accredited Social Health Activist (ASHA) to enlist women who desire a baby in one year. From the list, eight to twelve women were invited to sub centre for FGDs, which were conducted in June 2018.Results A total of 76 women having mean age 23.97 years participated in the FGDs. Most of them (46.05%) had completed 10 years of education. About 50% of pregnancies are planned. The decision about first pregnancy is influenced by the mother-in-law. Women knew that they should not conceive before 20 years of age and their inadequate weight may have adverse impact on the health of new-born. Women had some knowledge about adverse effects of tobacco and alcohol use, very few consumed these. Most of them did not practice behaviours or accessed services related to PCC.
N-CAM expression: The study of muscle disease in a tertiary center of Thailand
Authors: Laoyoung Kanyarat , Waisayarat Jariya
Published: May 2020

Background

The neural cell adhesion molecule (N-CAM), also called CD56, is a cell-surface glycoprotein that mediates intercellular adhesive interactions in the nervous system. N-CAM is expressed in neuromuscular endplates, nerves, satellite cells, and embryonic muscle, but it is lost as development proceeds and is nearly absent from adult muscle. N-CAM re-expression was detected in a denervated, regenerating and degenerated muscle fibres. Muscle disease or myopathy is diagnosed based on the presence of denervated, regenerating and degenerated fibres on muscle biopsy combined with clinical information. Some regenerating fibres looked like normal fibre and were challenging to identify but showed positive N-CAM staining.
Objectives

To explore the expression of N-CAM in muscle disease.
Methods

N-CAM expression and interpretation were performed in a 3-year retrospective study of 75 muscle biopsies diagnosed with myopathies. The pathological findings and clinical information were also thoroughly reviewed.
Results

Of 75 myopathy patients, 41 (55%) cases were female, and 34 (45%) cases were male. The mean age was 35 years. The range of age was 3 months to 83 years. The expression of N-CAM and clinical information, including pathological findings, were analyzed using Fisher’s exact versus chi-square tests. N-CAM expression data was performed in 75 samples, 35 (46.67%) were positive for N-CAM, and 40 (53.33%) were negative for N-CAM. The diagnosis of the muscle disease was nonspecific myopathy with 35 (46%) cases, inflammatory myopathy with 17 (23%) cases, neurogenic myopathy with 9 (12%) cases, muscular dystrophy with 7 (9%) cases, non-diagnostic myopathy with 5 (7%) cases, and mitochondrial myopathy with 2 (3%) cases. The inflammatory myopathy showed positive N-CAM in 15 out of 17 cases with statistical significance (p-value < 0.001, ORs (95% CI) 14.250 (2.960-68.606)). N-CAM was also positive in muscular dystrophy, neurogenic myopathy, and nonspecific myopathy but was not statistically significant in p-value. No positive N-CAM was found in mitochondrial myopathy and non-diagnostic myopathy.
Conclusion

N-CAM expression accompanied by the pattern of staining could be considered to help narrow down the differential diagnosis of myopathies. We recommend further study in a larger group.
Local treatment combined with chemotherapy improves survival of patients with pulmonary metastases of colorectal cancer—a real-world retrospective study
Authors: Cai Zikai , Wang Qingbing , Yang Xiaofeng , Ye Xiaolong , Fang Jiafeng , Chen Tufeng , Lei Purun , Zheng Zongheng , Xiao Jian’an , Wei Bo , Wei Hongbo
Published: May 2020

Background The effect of local treatments for pulmonary metastases from colorectal cancer (CRC-PM) remains controversial. This study aims to figure out whether local treatments combined with chemotherapy could improve patients’ survival by comparing the outcomes of CRC-PM patients who submitted to local interventions combined with chemotherapy or just chemotherapy.Patients and Methods From January 2009 to July 2019, a total of 119 patients with CRC-PM from two surgical centers were reviewed. Patients were divided into two groups according to treatments for the lung metastases: Local intervention combined with chemotherapy (Group-LI) and Chemotherapy alone (Group-Chem). Overall survival (OS) and progression-free survival (PFS) were assessed with the Kaplan-Meier method. Clinical characteristics associated with prognosis were analyzed by using a Cox proportional hazards regression model. Propensity score matching analyses were used to overcome the possible biases in some baseline characteristics.Result Multivariable analysis revealed that the level of carcinoembryonic antigen (CEA) and treatment for CRC-PM are independent predictors of both OS and PFS. The median OS in Group-LI (n = 39) and Group-Chem (n = 80) were 34.5 months and 13.8 months, respectively(P < 0.001). The 3-year progression-free survival rate in Group-LI and Group-Chem were 75.2% and 45.1% (P < 0.001). After propensity score matching, patients in Group-LI had better OS (HR = 3.304, P = 0.022) and PFS (HR = 4.029, P < 0.001) than Group-Chem.Conclusion. CRC-PM patients with lower lever of CEA or local treatment of lung metastases are more likely to be those with favorable prognosis. Selected CRC-PM patients could benefit from local treatment of pulmonary metastases.
How should community health workers in fragile contexts be supported: Qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo
Authors: Raven Joanna , Wurie Haja , Idriss Ayesha , Bah Abdulai Jawo , Baba Amuda , Nallo Gartee , Kollie Karsor K. , Dean Laura , Steege Rosie , Martineau Tim , Theobald Sally
Published: May 2020

Background Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents.Results Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs scope of work is varied and may change over time, requiring ongoing training. The modular, local, and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and develop a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery.Conclusions This is the first study that has explored the management of CHWs in fragile settings. CHWs interface role between communities and health systems is critical because of their embedded positionality and the trust they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.
Effect of maternal dietary supplementation with Brazil nut (Bertholletia excelsa) on the nutritional profile of human milk: randomized controlled trial - rationale, design, and methods
Authors: Rodrigues Denise , Reis Roberta Sena , Correa Kely de Paula , Franceschini Sylvia do Carmo Castro , Coimbra Jane Selia dos Reis
Published: May 2020

Background The human milk (HM) composition reflects the nutritional status and dietary intake of the nursing mother, especially regarding the fatty acids (FA) intakes. Evidence has shown that Brazil nut is a good source of FA (mono and polyunsaturated) and selenium. Thus, this study tests the hypothesis that the consumption of this nut during lactation can modify the nutritional profile of HM, increase its energy density and selenium content, and improve the lipid profile. Therefore, this study aimed to describe the design and methods of the Randomized Clinical Trial (RCT): Effect of maternal dietary supplementation with Brazil nut (Bertholletia excelsa) on the nutritional profile of HM. Method/Design It is a crossover study, conducted with mother-infant dyads (with infants born at full-term) recruited from a maternity hospital and followed up to the third month postpartum in a pediatric office. Sociodemographic, lifestyle, obstetric, and birth data were collected at 7 days postpartum. Maternal nutrition assessment data (anthropometry, body composition, food intake, biochemical tests), HM samples, and infant anthropometric and health assessment data were collected on average at 37, 52, 75, and 90 days postpartum. The nursing mothers were randomly allocated into two groups: group (1) started with supplementation of 1.5 g/day Brazil nut (case) for 15 days, followed by 15-day washout period; after the washout, the group was then considered as control and received follow-up monitoring for another 15 days; group (2) started as control for 15 days, which was followed by a washout period of 15 days, then they initiated supplementation with Brazil nut for 15 days (case).Discussion To the best of our knowledge, this is the first RCT to evaluate the effect of maternal Brazil nut supplementation on HM nutritional profile. This is a promising research area that can provide findings which will contribute to improving health and nutrition of infants, especially premature infants, admitted to Neonatal Intensive Care Units.
Impact of Retrieved Lymph Nodes Count on Short-term Complications in Patients With Gastric Cancer: A Retrospective Study
Authors: Sun Feng , Liu Song , Song Peng , Zhang Chen , Liu Zhijian , Guan Wenxian , Wang Meng
Published: May 2020

Background:It is well established thatretrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery.Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count.Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNscount and postoperative complications (both overall and stratified by CDC grade). We further explored that preoperative serum albumin, type of resection, operation time, tumor invasion, lymph node metastasis, and pTNM stage were associated with RLNs count.Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.
Screening of postpartum depression among new mothers in Istanbul: a psychometric evaluation of the Turkish Edinburgh Postnatal Depression Scale
Authors: Boran Perran , Waqas Ahmed , Askan Öykü Ozboru , Topçu İrem , Dogan Tugay , Rahman Atif
Published: May 2020

Objective This study is the first concerted effort to ascertain factor structure of EPDS using evidence based analytical techniques. It is the most widely used scale for assessing postpartum depression in Turkey, and yet no investigations have been conducted to assess it factor structure. This study was conducted from April 2012 to April 2018 at the Marmara University Hospital operating under the name of Marmara University Pendik Training and Research Hospital in Istanbul Turkey. Results A total of 1700 women were included in this study, who responded to the EPDS, in addition to demographic characteristics and well-being of their offspring. A total of 1615 mothers provided adequate data for inclusion in analysis. Standardized Chronbach’s alpha for EPDS was 0.81 with corrected item-total correlations ranging from 0.35 to 0.62. Parallel analysis, MAP Velicer Test and Hull’s method dictated retaining of one factor structure. All the items revealed adequate communalities (> 0.20) except item 2 (enjoyment) and item 10 (self-harm). Their communalities were 0.16 and 0.19, however, these items were not dropped. All of the items yielded moderate to strong factor loadings. Minimum factor loading was for item 2 (0.40) and highest for item 8 (0.71).
Establishment of Reference Range of CD4 T-Lymphocyte in Healthy Nepalese Adults
Authors: Mishra Shravan Kumar , Shrestha Lilee , Pandit Roshan , Khadka Sundar , Shrestha Bimal , Dhital Subhash , Sharma Saroj , Sharma Mukunda , Mahato Raj Kumar , Shakya Geeta , Manandhar Krishna Das
Published: May 2020

Objective CD4 T Lymphocytes are the most widely used cellular markers to assess the course of HIV infection, clinical staging and, monitoring the effect of antiretroviral therapy. The regional reference range for Eastern, Central and Western development region of Nepal had already been established whereas the same was still lacking in Mid-western and Far-western development region. The objective of this study was to establish reference range of CD4 T Lymphocyte in the remaining two development regions and finally the national reference range using data from previous study.Results The average values (mean ± SD) of CD4 and CD3 T cell in present study was (819 ± 294) cells/µl and (1546 ± 532) cells/µl, respectively. The absolute CD4 T cell (914 ± 303) and CD3 T cell (1671 ± 560) count in female were significantly higher than those from male, CD4 (757 ± 270) and CD3 (1465 ± 499) (p value − 0.000). National reference value of CD4 was determined to be (798 ± 335) cells/µl for healthy Nepalese adults.
“I’m not a teenager, I’m 22. Why can’t I snap out of it?” A Qualitative Exploration of Seeking Help for a First-Episode Eating Disorder During Emerging Adulthood
Authors: Potterton Rachel , Austin Amelia , Allen Karina , Lawrence Vanessa , Schmidt Ulrike
Published: May 2020

Background Eating disorders (EDs) are serious mental illnesses which typically have their onset during adolescence or the transition to adulthood. Emerging adulthood (EA) (~ 18–25 years) is a developmental phase which conceptually overlaps with adolescence (e.g. both are key periods for identity development) but also has unique characteristics (e.g. increased independence). EA may be a risk-period for delayed help-seeking for EDs, compared to adolescence.Objective This study aimed to explore emerging adults’ attitudes towards their ED symptoms, and their implications for help-seeking. Method: Participants were 14 emerging adults (mean age 20.9 years; SD = 2.0), all currently receiving specialist treatment for a first-episode, recent-onset (< 3 years) ED. Semi-structured interviews relating to experiences of help-seeking were conducted, and data were analysed thematically.Results Symptom egosyntonicity, gradual reappraisal and stereotypical beliefs about EDs were key attitudinal stages prior to help-seeking. Each attitude had distinct implications for help-seeking (e.g. superficial help-seeking; scaffolding by others; helps-seeking at transitions; self-sufficiency, indirect disclosure).Conclusions Emerging adults with first-episode EDs show a distinct set of help-seeking-related challenges and opportunities. These may justify policies and practice tailored specifically to this population group.
EIF4A3-Mediated CircRNA_100290 Promotes GC Cell Proliferation, Invasion and EMT via miR-29b-3p/ITGA11 Axis
Authors: Wang Gang , Sun Dan , Li Wenhui , Xin Yan
Published: May 2020

Background Circular RNA (circRNA) has been reported as an important regulator in the development and progression of various carcinomas. However, the role of circRNA_100290 in gastric cancer (GC) is still unclear. This study aimed to investigate the role of circRNA_100290 in GC invasion and metastasis and its possible mechanism.Methods The expression of circRNA_100290 in GC cells and tissues were examined using quantitative real-time polymerase chain reaction (qRT-PCR). The role of circRNA_100290 in cell proliferation, migration, and invasion was evaluated on AGS and HGC-27 cell lines in vitro. Bioinformatics tools, dual-luciferase reporter assay, Western blot assay and qRT-PCR were used to explore the downstream pathways of circRNA_100290. The mechanism underlying the regulation of the expression of circRNA_100290 was explored using RNA immunoprecipitation, qRT-PCR, and Western blot assays.Results The expression of circRNA_100290 was found significantly upregulated in GC cells and 102 GC tissues, high expression of circRNA_100290 in GC was closely related to Borrmann’s types, lymph node metastasis and tumor-node-metastasis staging. In vitro, knockdown of circRNA_100290 in AGS and HGC-27 cells significantly inhibited cell proliferation, migration, and invasion. Mechanistically, dual-luciferase reporter assay confirmed a direct binding between circRNA_100290 and miR-29b-3p, which targets ITGA11, an oncogene which is closely related to epithelial–mesenchymal transition (EMT). In addition, EIF4A3, one of RNA binding proteins (RBPs), could inhibit the formation of circRNA_100290 via enriching flanking sites of circRNA_100290. Low expression of EIF4A3 in GC was related to a worse prognosis.Conclusions Elevated circRNA_100290 in GC promotes cell proliferation, invasion and EMT via miR-29b-3p/ITGA11 axi and might be regulated by EIF4A3. CircRNA_100290 might be a promising biomarker and target for GC therapy.
Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases
Authors: Yan Xiaorong , Wang Huiqing , Li Cai , Lin Yuanxiang , Lin Lin , Zhu Shinong , Wang Chenyang , Lin Zhangya , Jiang Changzhen , Kang Dezhi
Published: May 2020

Background
To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique.
Methods
In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis.
Results
All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity.
Conclusion
The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.
Structure based drug discovery by virtual screening of 3699 compounds against the crystal structures of six key SARS-CoV-2 proteins
Authors: Saadat Shoab , Mansoor Salman , Naqvi Naveen , Fahim Ammad , Rehman Zaira , Khan Shahar Yar , Saadat Sidra
Published: May 2020

BackgroundThe current Novel Coronavirus (SARS-CoV-2) pandemic is the third major outbreak of the 21st century which emerged in December 2019 from Wuhan, China. At present there are no known treatments or vaccines to cure or prevent the illness.ObjectiveThe objective of this study was to explore a list of potential drugs (herbal and antivirals) for their role in inhibiting activity and or replication of SARS-CoV-2 by using molecular docking onto the crystal structures of key viral proteins.MethodologyIn this study, we used molecular docking to estimate the binding affinities of 3699 drugs on the potential active sites of the 6 main SARS-CoV-2 proteins (Papain like protease, Main protease, ADP Ribose phosphatase, Spike protein, NSP-9 and NSP-10 to 16 complex). While other studies have mostly been performed on the homology models, we obtained the most recently submitted crystal structures of all 6 proteins from the protein data bank for this analysis.ResultsOur results showed the top ligands as Theasinensin A, Epigallocatechin, Theaflavin, Theasinensin A, Epigallocatechin and Favipiravir showing the highest binding affinities against papain-like protease, ADP ribose phosphatase, main protease, spike protein, RNA replicase (NSP-9) and methyl-transferase (NSP-16) respectively.ConclusionWe show that the compounds from our list with the greatest inhibitory potential against SARS-CoV-2 activity or replication include Theasinensin A, Epigallocatechin-3-gallate, Theaflavin, Favipiravir, Curucumin, Quercetin, Mitoxantrone, Amentoflavone, Colistin, Cimicifugic acid, Theaflavin, Silymarin and Chebulagic. We recommend further wet-lab and clinical testing of these compounds to further explore their role against SARS-CoV-2.
The Big-Five personality traits and quality of life in elderly Malaysian patients with diabetes mellitus: A cross-sectional study
Authors: Woon Luke Sy-Cherng , Gosse Paula Junggar , Kaunismaa Emily Samantha , Mainland Roslyn Laurie , Ravindran Arun , Mustafa Norlaila , Sidi Hatta
Published: May 2020

Background: Diabetes mellitus is highly prevalent in the elderly population, with a significant impact on quality of life. This study aimed to explore the relationship between personality traits and quality of life in an elderly population with diabetes. Methods: A cross-sectional study was conducted at the Universiti Kebangsaan Malaysia Medical Center. Outpatients above 60 years old with a diagnosis of type 1 or type 2 diabetes mellitus were recruited. Sociodemographic and clinical information were obtained. Quality of life was assessed using the WHO Quality of Life-BREF questionnaire and personality traits were assessed using the Big Five Inventory questionnaire. Depression and anxiety were measured with Beck Depression Inventory and Generalized Anxiety Disorder 7-item scale respectively and controlled for in statistical analyses. Results: There were 170 study participants (median age=69.0 years; IQR: 65.0-73.0; 51.2% male). In stepwise linear regression models, higher conscientiousness scores (β=0.156; p=0.044) and lower neuroticism scores (β=-0.176; p=0.028) were associated with greater quality of life in the physical health domain. Higher extraversion scores (β=0.209; p=0.001) and higher conscientiousness scores (β=0.248; p<0.001) were associated with greater quality of life in the psychological health domain. Higher agreeableness scores (β=0.286; p<0.001) were associated with greater quality of life in the social relationship domain. Finally, higher agreeableness scores (β=0.327; p<0.001) and lower neuroticism scores (β=-0.223; p=0.001) were associated with greater quality of life in the environment domain. Conclusions: Personality traits were closely associated with all domains of quality of life among elderly patients with diabetes mellitus. Premorbid personality may have important role in moderating the impact of diabetes mellitus on the lives of elderly patients.