bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of Education Quality and Influence of Language Barrier: Graduation Survey of International Medical Students at Four Universities in China
Authors: Li Wen , Liu Chang , Liu Shenjun , Zhang Xin , Shi Rong-gen , Jiang Hailan , Ling Yi , Sun Hong
Published: November 2020

Background: As the number of Asian and African students studying medicine in China increases, it is imperative to evaluate the educational experiences of these international medical students (IMSs). This study was intended to investigate opinions of China-educated IMSs towards the medical curriculum and the impact of Chinese language capability on their clinical studies.Methods: A self-administered questionnaire was circulated to the final-year IMSs during the graduation time from May 2019 to July 2019 in 4 universities in China. The questionnaire asked IMSs to assess the quality of medical education and provide a self-evaluation of their Chinese language capability. One-way Analysis of Variance (ANOVA) was used to determine whether IMSs’ Chinese language capability was associated with their clinical experiences and clinical competence.Results: Overall, we received 209 valid responses, of which 76.1% were satisfied with the quality of medical education. Genetics, physics, and mathematics were perceived as the least relevant basic courses for medical practice, and 21.5% of student reported that community-oriented medicine was a neglected subject. Notably, 58.9% of students had positive views about discussions on ethical topics during their clerkships, and 71.3% believed they had acquired sufficient clinical skills to begin a residency program. Chinese speaking skills and communication initiatives were found to be critical factors in influencing students’ clinical experiences and competence. Conclusion: This study presents the perceptions of China-educated IMSs towards medical curriculum from various aspects. Results show that language influences the education experiences of IMSs. Collectively, these results indicate that the curriculum for IMSs in China should be more problem-based and community-engaged to improve IMSs’ learning experiences and preparation for community deployment. Furthermore, training curriculum for the oral Chinese should be improved to equip IMSs with sufficient language competence to enable them to efficiently carry out clinical clerkship and rotations. Our findings provide evidence for benchmarking medical curricular codifications tailored for Asian and African students.
Effects of variable frequencies of kinesthesia, balance and agility exercise program in adults with knee osteoarthritis: study protocol for a randomized controlled trial
Authors: Adhama Aysha I. , Akindele Mukadas O. , Ibrahim Aminu A.
Published: November 2020

Background: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal treatment dosage of KBA exercise is still unclear. The aim of this study is to determine the effects of different frequencies of KBA treatment (i.e. twice-weekly or thrice-weekly) in adults with knee OA.Methods: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. Eighty-four adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 28), thrice-weekly KBA (n = 28), and conventional physiotherapy or control (n = 28) in the ratio of 1:1:1. Participants in the conventional therapy group will receive two sessions of brief patient education, and 16 sessions of ultrasound therapy, stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA exercise according to the designed sessions for 8 weeks in addition to the conventional therapy. All groups will be assessed pre-intervention, immediately post-intervention and at 8 weeks, 3-month, 4-month, and 6-month post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) while the secondary outcomes will be pain (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire).Discussion: Findings of this study may provide evidence on the effectiveness of KBA exercise and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA.Trial registration: Pan African Clinical Trials Registry, (PACTR201810713260138), Retrospectively registered on 28 November 2017.
Long non-coding RNA SNHG15 in various cancers: a meta and bioinformatic analysis
Authors: Chen Caizhi , Feng Yeqian , Wang Jingjing , Liang Ye , Zou Wen
Published: November 2020

Background: The snoRNA host gene SNHG15 produces a long non‐coding RNA (lncRNA) with a short half-life and has been reported to be dysregulated in multiple cancers and has recently been found to be correlated with tumour progression. Therefore, this meta-analysis was performed to evaluate the generalised prognostic role of small nucleolar RNA host gene 15 (SNHG15) in malignancies, based on variable data from different studies.Methods: Four public databases were used to identify eligible studies. The association between prognostic indicators and clinical features was extracted and pooled to estimate the hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was measured using Begg’s test and Egger’s test, and the stability of pooled results were measured using sensitivity analysis. Additionally, an online database based on The Cancer Genome Atlas (TCGA) was screened to further validate our results. Ultimately, we predicted the molecular regulation of SNHG15 based on the public databases.Results: In total, 11 studies including 1,087 patients were ultimately enrolled in our meta-analysis. We found that SNHG15 overexpression was associated with worse overall survival (OS) and disease-free survival (DFS), and this was validated in the Gene Expression Profiling Interactive Analysis (GEPIA) cohort. Moreover, increased SNHG15 expression suggested advanced TNM stage and LNM, but was not associated with age, gender, or tumour size. No publication bias or instability of the results was observed. SNHG15 was significantly upregulated in seven cancers and elevated expression of SNHG15 indicated shorter OS and DFS in five malignancies based on the validation using the GEPIA cohort. Further functional prediction indicated that SNHG15 may participate in some cancer-related pathways.Conclusions: Upregulation of lncRNA SNHG15 was notably associated with worse prognosis and clinical features, suggesting that SNHG15 might serve as a novel prognostic factor in various cancers.
Pediatric Resident’s Perception of Night Float System Compared to 24 Hours System, a Prospective Study 
Authors: Alsohime Fahad , Alkhalaf Hamad , Almuzini Hissah , Alyahya Malak , Allhidan Reema , Assiry Ghadeer , AlSalman Munirah , Alshuaibi Walaa , Temsah Mohamad-Hani , Alakeel Abdullah , Aleyadhy Ayman
Published: November 2020

Background:This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents (PGY-3 & PGY-4) enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses (1 means strongly disagree & 5 means strongly agree), covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples.Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system was perceived to have less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system was perceived to have less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001).Conclusion: The senior residents’ perception about the 24-hour on-call system has shown a negative impact on the residents’ well-being and education of residents and patient safety compared to an on-call system with more restrictive duty hours. The perception of the restricted duty hours was perceived to be less harmful, more useful from pedagogic aspect and has positive impact on the quality of delivered health care services.
Changes in treatment strategy over time for arteriovenous malformation in a Japanese high-volume center
Authors: Komatsu Katsuya , Takagi Yasushi , Ishii Akira , Kikuchi Takayuki , Yamao Yukihiro , Yoshida Kazumichi , Miyamoto Susumu
Published: November 2020

Background: Despite rapid developments in devices used to treat arteriovenous malformation (AVM), a randomised trial of Unruptured Brain Arteriovenous malformations published in 2014 recommended conservative treatment for nonhemorrhagic AVM. The purpose of the current retrospective study was to confirm how AVM treatment in Japan has changed and to assess the safety of treatment for hemorrhagic and nonhemorrhagic AVMs.Methods: We enrolled 242 consecutive patients with AVM; each patient’s treatment was selected and performed at our hospital. The type of onset, Spetzler–Martin (S–M) grade, age, sex, selected treatment, mortality, and morbidity were compared between the first and second periods of our study.Results: In patients with grade I–III AVM, the selected treatment changed between the first and second periods; however, in grade IV and V patients, the selected treatment did not change. Overall, interventions by microsurgery alone decreased (p < 0.001), the proportion of total treatments including microsurgery decreased (p = 0.005), interventions using stereotactic radiosurgery (SRS) alone increased (p = 0.009), and interventions including SRS increased (p = 0.002). Morbidity associated with intervention was 0.92% in the first period and 0% in the second period, and mortality was 0.92% in the first period and 1.67% in the second. Conclusions: With the development of new devices, the selected treatment was changed in patients with S–M grade I–III AVM, but was not changed in patients with grade IV and V. The complication rate was low and did not change throughout the periods. These findings suggest that the safety of treatment depends on a full understanding of device development and the selection of proper treatment, not on hemorrhagic onset. Further treatment innovations are expected to change the treatment for grade IV and V AVMs.
Integrated 3D printing solution to mitigate shortages of airway consumables and personal protective equipment during the COVID-19 pandemic
Authors: Fillat-Gomà Ferran , Coderch-Navarro Sergi , Martínez-Carreres Laia , Monill-Raya Núria , Nadal-Mir Toni , Lalmolda Cristina , Luján Manel , de Haro Candelaria , Blanch Lluís
Published: November 2020

Background: To cope with shortages of equipment during the COVID-19 pandemic, we established a nonprofit end-to-end system to identify, validate, regulate, manufacture, and distribute 3D-printed medical equipment. Here we describe the local and global impact of this system. Methods: Together with critical care experts, we identified potentially lacking medical equipment and proposed solutions based on 3D printing. Validation was based on the ISO 13485 quality standard for the manufacturing of customized medical devices. We posted the design files for each device on our website together with their technical and printing specifications and created a supply chain so that hospitals from our region could request them. We analyzed the number/type of items, petitioners, manufacturers, and catalogue views. Results: Among 33 devices analyzed, 26 (78·8%) were validated. Of these, 23 (88·5%) were airway consumables and 3 (11·5%) were personal protective equipment. Orders came from 19 (76%) hospitals and 6 (24%) other healthcare institutions. Peak production was reached 10 days after the catalogue was published. A total of 22,135 items were manufactured by 59 companies in 18 sectors; 19,212 items were distributed to requesting sites during the busiest days of the pandemic. Our online catalogue was also viewed by 27,861 individuals from 113 countries.Conclusions: 3D printing helped mitigate shortages of medical devices due to problems in the global supply chain.
Survey on neutralizing antibodies against Zika virus eighteen months post-outbreak in two southern Thailand communities
Authors: Densathaporn Theerut , Sangthong Rassamee , Sakolnapa Monvaris , Surasombatpattana Smonrapat , Kemapunmanus Marisa , Masrinoul Promsin , Yoksan Sutee , McNeil Edward B , Chongsuvivatwong Virasakdi
Published: November 2020

Background: In 2016 and 2017, Zika virus (ZIKV) infection outbreaks occurred in two communities in southern Thailand. This re-immerging infection can widely spread by mosquito bites and cause serious complications in a central nervous system among children born to infected mothers. Thus, they should be protected. This study aims to (1) To determine the prevalence of neutralizing ZIKV antibodies in the post-outbreak areas among the general population and pregnancy women residing at various distances from the houses of the nearest index patients; (2) To examine the cross-neutralizing capacity of antibodies against ZIKV on other flaviviruses commonly found in the study areas; (3) To identify factors associated with the presence of neutralizing ZIKV antibodies.Methods: The two post-outbreak communities were visited at 18 months after the outbreaks. We enrolled (1) 18 confirmed ZIKV infected (index) cases, (2) sample of 554 neighbors in the outbreak areas who lived at various distances from the index patients’ houses, (3) 190 residents of non-outbreak areas, and (4) all pregnant women regardless of gestational age residing in the study areas (n = 805). All serum specimens underwent the plaque reduction neutralization test (PRNT). Ten randomly selected ZIKV seropositive and ten randomly selected seronegative specimens were tested for dengue virus serotypes 1-4 (DENV1-4) and Japanese encephalitis virus (JEV) antibodies using PRNT90. Serum titer above 1:10 was considered positive. Multiple logistic regression was used to assess factors associated with seropositivity.Results: Out of all 18 index cases, 9 remained seropositive. The seroprevalence (95% CI) in the two outbreak areas were 43.7% (35.9-51.6%) and 29.7% (23.3-36.0%) in general population, and 24.3% (20.1-28.8%) and 12.8% (9.7-16.5%) in pregnant women. Multivariate analysis showed that seropositivity was independent of the distance gradient from the index’s houses. However, being elderly was associated with seropositivity. DENV1-4 and JEV neutralizing antibodies were present in most ZIKV-positive and negative subsamples.Conclusion: Protective herd immunity for ZIKV infection is inadequate, especially among pregnant women in the two post-outbreak areas in southern Thailand.
Examining aptitude and barriers to Evidence Based Medicine among trainees at an ACGME-I accredited program
Authors: Mahmoud Mai , Laws Saad , Kamal Antoun , Mohanadi Dabia Al , Mohammed Ahmed Al , Mahfoud Ziyad
Published: November 2020

BackgroundThe aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome1. Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. MethodsClinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. ConclusionsWhile it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.
Association of serum calcium levels with renal impairment and all-cause death in Chinese patients with newly diagnosed multiple myeloma: A cross-sectional, longitudinal study
Authors: Cheng Jun , Zhang Wen , Zhao Yi , Li Xiayu , Lv Rong , Li Heng , Jianghua Chen
Published: November 2020

Background: More studies have shown that serum calcium has a crucial role in many types of cancers. However, few studies have determined the association between serum calcium levels and renal impairment (RI) and all-cause death in Chinese patients with multiple myeloma (MM).Methods: A total of 246 of 565 participants who were followed for > 6 months from a MM cohort at our institution were eligible for the retrospective study. A generalized additive model and smooth curve fitting were performed to investigate the cross-sectional relationship between the serum calcium level and RI at baseline. Multivariate-adjusted Cox regression models were fitted to assess the associations between baseline serum calcium levels and the onset of end-stage renal disease (ESRD) or death in patients with MMResults: A total of 172 of 565 patients (30.4%) with newly diagnosed MM presented with RI. The mean duration of follow-up was 26.64 months. Twenty-one patients (8.54%) died and 28 patients (11.52%) had ESRD. In patients with a serum calcium level >2.30 mmol/L, the serum calcium level was independently associated with the occurrence of MM-related RI. Cox regression analysis showed that baseline serum calcium levels were consistently associated with a higher risk of all-cause death in the fully adjusted model, but were not associated with the occurrence of ESRD. When patients were categorized into two groups according to baseline mean serum calcium level, deaths occurred in 13 patients (15.1%) with a mean serum calcium level > 2.44 mmol/L compared to eight patients (5.0%) with a mean serum calcium level < 2.44 mmol/L (p < 0.05); Eighteen patients (11.46%) with a mean serum calcium level < 2.44 mmol/L progressed to ESRD compared to 13 patients (11.6%) with a serum calcium level > 2.44 mmol/L (p > 0.05).Conclusions: This observational study showed that there was a nonlinear relationship between the serum calcium level and the presence of RI in patients with MM.An elevated baseline calcium level predicted all-cause death, but did not predict the occurrence of ESRD in patients with MM followed for > 6 months.
Population migration, spread of COVID-19, and epidemic prevention and control: empirical evidence from China
Authors: Hu Zhen , Wu Yuanyang , Yang Hualei , Lin Xie , Zhang Anqi , Lin Xueyu , Nie Yafeng
Published: November 2020

Background: This study applied the SEIR model to analyze and simulate the transmission mechanisms of the coronavirus disease 2019 (COVID-19) in China. Methods: The population migration was embedded in the SEIR model to simulate and analyze the effects of the amount of population inflow on the number of confirmed cases. Based on numerical simulations, this study used statistical data for the empirical validation of its theoretical deductions and discussed how to improve the effectiveness of epidemic prevention and control considering population migration variables. Statistics regarding the numbers of infected people in various provinces were obtained from the epidemic-related data reported by China’s National Health Commission.Results: This study explored how the epidemic should be prevented and controlled from the perspective of population migration variables. It found that a combination of a susceptible population, an infected population, and transmission media was an important route affecting the number of infections and that the migration of a Hubei-related infected population played a key role in promoting epidemic spread. Epidemic prevention and control should focus on regions with better economic conditions than the epidemic region. Prevention and control efforts should focus on the more populated neighboring provinces having convenient transportation links with the epidemic region. To prevent and control epidemic spread, priority should be given to elucidating the destinations and directions of population migration from the domestic origin of infections, and then stemming population migration or human-to-human contact after such migration. Conclusions: This study enriched and expanded on simulations of the effects of population migration on the COVID-19 epidemic and China-based empirical studies while offering an epidemic evaluation and warning mechanism to prevent and control similar public health emergencies in the future.
The Double-Edged Sword Effect of Macrophage Targeting Delivery System in Different Macrophage Subsets Related Diseases
Authors: Yuan Yuchuan , Long Ling , Liu Jiaxing , Lin Yongyao , Peng Cuiping , Tang Yue , Zhou Xuemei , Li Shuhui , Zhang Chengyuan , Li Xiaohui , Zhou Xing
Published: November 2020

Background: Monocyte/macrophage-targeting delivery systems (MTDSs) have been focused upon as an emerging routine for delivering drugs to treat various macrophage-related diseases. However, the ability of MTDSs to distinguish different macrophage-related diseases and their impact on macrophage function and disease progression have not been systematically revealed, which is important for actively targeted therapeutic or diagnostic strategies. Results: Herein, we used dextran-modified polystyrene nanoparticles (DEX-PS) to demonstrate that modification of nanoparticles by dextran can specifically enhance their recognition by M2 macrophages in vitro, but it is obstructed by monocytes in peripheral blood according to in vivo assays. DEX-PS not only targeted and became distributed in tumors, an M2 macrophage-related disease, but was also highly distributed in an M1 macrophage-related disease, namely acute peritonitis. Thus, DEX-PS acts as a double-edged sword in these two different diseases by reeducating macrophages to a pro-inflammatory phenotype. Conclusions: Our results suggest that MTDSs, even those designed based on differential expression of receptors on specific macrophage subtypes, lack the ability to distinguish different macrophage subtype-related diseases in vivo. In addition to the potential impact of these carrier materials on macrophage function, studies of MTDSs should pay greater attention to the distribution of nanoparticles in non-target macrophage-infiltrated disease sites and their impact on disease processes.
Sleep disturbances and depressive and anxiety symptoms during pregnancy: associations with delivery and new-born health
Authors: Peltonen Hilla , Paavonen Ella Juulia , Saarenpää-Heikkilä Outi , Vahlberg Tero , Paunio Tiina , Polo-Kantola Päivi
Published: November 2020

Background: Sleep disturbances and mood symptoms are common in late pregnancy and they contribute to the decline in daytime quality of health and life in expecting mothers. This study evaluated the effect of these disturbances on delivery and new-born health as these associations have been insufficiently covered in the previous literature.Methods: A cohort of 1414 mothers was enrolled in the third trimester to this prospective cross-sectional questionnaire study. Basic Nordic Sleep Questionnaire was assessed for measurement of sleep quality and sleep length, Epworth sleepiness scale for sleepiness, the Center for Epidemiologic Studies Depression Scale for depression and State-Trait Anxiety Inventory for anxiety. The data on delivery and new-born outcomes was obtained from hospital medical records.Results. Sleep disturbances were very common during pregnancy. Higher insomnia score (β = -0.06, p = 0.047) and longer sleep need (β = 0.07, p = 0.047) were related to delivery at a lower gestational age. In addition, higher insomnia score (β = -28.30, p = 0.010) and lower general sleep quality (β = -62.15, p = 0.025) were associated with lower birth weight. Instead, longer sleep duration and longer sleep need with higher birth weight (β = 28.06, p = 0.019; β = 27.61, p = 0.028, respectively). However, these findings regarding birth weight lost their significance when the birth weight was standardized with gestational weeks. Snoring was associated with a shorter duration of the 1st phase (β = -78.71, p = 0.015) and total duration of delivery (β = -79.85, p = 0.016). Mothers who suffered from high insomnia, depressive or anxiety symptoms were more often treated with oxytocin (OR 1.54 95% CI 1.00-2.38, p = 0.049, OR 1.76, 95% CI 1.02-3.04, p = 0.049 and OR 1.91, CI 95% 1.28-2.84, p < 0.001, respectively) and very depressive and anxious mothers delivered more often with elective caesarean section (OR 4.67, 95% CI 2.04-12.68, p < 0.001 and OR 2.22, 95% CI 1.03-4.79, p = 0.042).Conclusions: Maternal sleep disturbances and mood symptoms during pregnancy are associated with delivery and new-born health. However, in this normative sample nearly all the outcomes fell within a normal range, implying that the actual risks are low.
The COX-2-derived PGE2 autocrine contributes to bradykinin-induced matrix metalloproteinase-9 expression and astrocytic migration via STAT3 signaling
Authors: Lee Tsong-Hai , Liu Pei-Shan , Tsai Ming-Ming , Chen Jiun-Liang , Wang Su-Jane , Hsieh Hsi-Lung
Published: November 2020

Background: The matrix metalloproteinase-9 (MMP-9) is up-regulated by several proinflammatory mediators in the central nervous system (CNS) diseases. Increasing reports show that MMP-9 expression is an inflammatory biomarker of several CNS disorders, including the CNS inflammation and neurodegeneration. Bradykinin (BK) is a common proinflammatory mediator and elevated in several brain injury and inflammatory disorders. The raised BK may be detrimental effects on the CNS that may aggravate brain inflammation through MMP-9 up-regulation or cyclooxygenase-2 (COX-2)-derived prostaglandin E2 (PGE2) production in brain astrocytes. However, the relationship between BK-induced MMP-9 expression and COX-2-derived PGE2 release in brain astrocytes remains unclear.Methods: Herein we used rat brain astrocytes (RBA) to investigate the role of the COX-2/PGE2 system in BK-induced MMP-9 expression. We used zymographic, RT-PCR, EIA, and Western blotting analyses to confirm that BK induces MMP-9 expression via a COX-2/PGE2-dependent pathway.Results: Our results show activation of native COX-2 by BK led to PGE2 production and release. Subsequently, PGE2 induced MMP-9 expression via PGE2 receptor (EP)-mediated c-Src, Jak2, ERK1/2, and then activated signal transducer and activator of transcription 3 (STAT3) signaling pathway. Finally, up-regulation of MMP-9 by BK via the pathway may promote astrocytic migration.Conclusion: These results demonstrated that a novel autocrine pathway for BK-induced MMP-9 protein expression is mediated through activation of STAT3 by native COX-2/PGE2-mediated c-Src/Jak2/ERK cascades in brain astrocytes.
Using Baidu search values to monitor and predict the confirmed cases of COVID-19 in China: – evidence from Baidu Index 
Authors: Tu Bizhi , Wei Laifu , Jia Yaya , Qian Jun
Published: November 2020

Background: New coronavirus disease 2019 (COVID-19) poses a severe threat to human life and causes a global pandemic. The purpose of current research is to explore whether the search-engine query patterns could serve as a potential tool for monitoring the outbreak of COVID-19.Methods: We collected the number of COVID-19 confirmed cases between January 11, 2020, and c, from the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). The search index values of the most common symptoms of COVID-19 (e.g., fever, cough, fatigue) were retrieved from Baidu Index. Spearman's correlation analysis was used to analyze the association between the Baidu index values for each COVID-19-related symptom and the number of confirmed cases. Regional distributions among 34 provinces/ regions in China were also analyzed. Results: Daily growth of confirmed cases and Baidu index values for each COVID-19 related symptoms presented a robust positive correlation during the outbreak (fever: rs=0.705, p=9.623×10-6; cough: rs=0.592, p=4.485×10-4; fatigue: rs=0.629, p=1.494×10-4; sputum production: rs=0.648, p=8.206×10-5; shortness of breath: rs=0.656, p=6.182×10-5). The average search-to-confirmed interval is 19.8 days in China. The daily Baidu Index value's optimal time lags were the fourth day for cough, third day for fatigue, firth day for sputum production, firth day for shortness of breath, and 0 days for fever. Conclusion: Search terms of COVID-19-related symptoms on the Baidu search engine have significant correlations with confirmed cases. Since the Baidu search engine can reflect the Public's attention to the pandemic and regional epidemics of viruses, relevant departments need to pay more attention to areas with high searches of COVID-19-related symptoms and take precautionary measures to prevent these potentially infected persons from further spreading.
BMSCs Seeding in Different Scaffold Incorporation with Hyperbaric Oxygen Treat Seawater Immersed Bony Defect
Authors: zhang gan , Chen Xiaosong , Cheng Xunsheng , Ma Xiuwu , Chen Congcong
Published: November 2020

Introduction: The experiment was undertaken to estimate the effect of BMSCs seeding in different scaffold incorporation with HBO on the repair of seawater immersed bone defect. And future compared n-HA/PLGA with β-TCP/PLGA as scaffold in treatment effect of seawater immersed bone defect.Methods: 60 New Zealand White rabbits with standard seawater defect in radius were randomly divided to group A (implant with nothing), group B (implanted with atuogenous bone), group C (implanted with n-HA/PLGA/BMSCs, and Group D ( implanted with β-TCP/PLGA/BMSCs). After implant, each rabbit receive HBO treatment at 2.4 ATA 100% oxygen for 120 minutes per day for 2 weeeks. Radiograph, histological and biomechanical examination were used to analyze osteogenesis.Result: X-ray analysis show that n-HA/PLGA/BMSCs and β-TCP/PLGA/BMSCs could accelerate the new bone formation, and the new bone formation in group C was lager than in group D or group A, and close to group B (P<0.05). After 12 weeks, in group A, defect without scaffold show a loose connect tissue filled in the areas. The medullary canal in group B was recanalizated. Defect in group C and D show a larger number of wove bone formation. The new wove bone formation in defect areas in group C was lager than D. The mechanical examination revealed ultimate strength at 12 weeks were group D>group C>group B>group A(P<0.05).Conclusion: Scaffold of n-HA/PLGA and β-TCP/PLGA incorporation with HBO and BMSCs were effective to treat seawater immersed bone defect, and n-HA/PLGA was more excellent than β-TCP/PLGA.
Effect of Seed Extraction Methods of Tomato on Physiological Quality of Seeds and Seedlings
Authors: Degwale Alemu , Tesfa Tiru , Meseret Belete
Published: November 2020

Background

Tomato (Solanum lycopersicum L.) belongs to the family Solanaceae is one of the most popular and most processed vegetable crops worldwide with a great nutritional contribution to the human diet. Though the demand for tomato products is increasing, its production is constricted by shortage of quality seeds due mainly to lack of appropriate seed extraction method. Inadequate seed extraction method also causes extensive disease epidemics. Conversely, empirical evidences are scanty on instant and latent effects of seed extraction methods. This study was therefore initiated to evaluate the effects of extraction methods on the physiological quality of seeds and seedlings of tomato.
Result

Results revealed that the highest germination percent (99.33 and 89.76% under laboratory and field conditions respectively) was obtained at 2% HCl for 60 minutes. Whereas, the maximum weight of 1000 seeds (4.277 g) was found at 1% of HCl for 30 minutes. Mycoflora load was maximum (36%) at fermentation for 72 hours. Yet, no mycoflora was detected from higher concentrations of HCl acid greater than 2% and time durations longer than 60 minutes.
Conclusion

the major seed quality parameters such as seed germination percent, seedling length, seedling fresh weight, seedling dry weight, and vigour indices were significantly higher at extraction method of 2% HCl for 60 minutes. Thus, it can be concluded that the maximum physiological seed quality and best performance of seedlings of tomato obtained from 2% HCl for 60 minutes seed extraction method of tomato.
Exploring general practitioners’ perceptions about the primary care gatekeeper role in Indonesia
Authors: Mulyanto Joko , Wibowo Yudhi , Kringos Dionne S.
Published: November 2020

Background In the current healthcare delivery system funded by National Health Insurance (NHI) in Indonesia, the gatekeeper role of primary care services is critical to ensuring equal healthcare access for the population. To be effective, gatekeeping relies on the performance of general practitioners (GPs). However, the perceptions held by Indonesian GPs about their gatekeeper role are not yet well documented. This study describes the self-perceived knowledge, attitudes and performance of Indonesian GPs with respect to the gatekeeper role and explores associated factors. Methods We conducted a cross-sectional study of all primary care facilities (N = 75) contracted by the regional NHI office in the Banyumas district. The 73 participating GPs completed a written questionnaire that assessed their knowledge, attitudes and performance in relation to the gatekeeper role. Personal and facility characteristics were analysed in a generalised linear model as possible associating factors.Results GPs scored relatively high in the domains of knowledge and performance but scored lower in their attitudes towards the gatekeeper role of primary care. In the full-adjusted model, no factors were significantly associated with the knowledge score. Work experience as GPs, private or civil service employment status and rural or urban location of the primary care facility were linked to attitude scores. Full- or part-time employment and type of facility were factors associated with the performance score. Conclusion GPs in Indonesia are knowledgeable and report that they adequately perform their function as gatekeepers in primary care. However, their attitudes towards the gatekeeper function are less positive. Attitudes and performance with respect to the primary care gatekeeper role are likely influenced more by contextual factors such as location and type of facility than by personal factors. Efforts to address contextual issues could include improvements in practice standards for privately practising physicians and public information campaigns about gatekeeping regulations. Such efforts will be crucial to improving the gatekeeper role of primary care in Indonesia and assuring efficient access to high-quality care for all.
Lipase-mediated interesterification of oils and fats for the preparation of bakery and confectionery fats
Authors: G HITHAMANI , Reddy Yella Sunki , Khatoon Sakina
Published: November 2020

Bakery and confectionary fats were prepared by enzymatic interesterification of sal fat with palm stearin and palm mid fraction blends in various ratios. Slip melting point, free fatty acids, fatty acid composition, solid fat content and triglyceride composition were determined. Fatty acid composition revealed that the blends were rich in palmitic (13.9-58.5%), stearic (7.7-36.7%) and oleic (25.2-39.9%) with no trans fatty acids. Blends of sal:PSt (50:50), sal:PMF (50:50 and 25:75) showed high solid fat content at 20 and 25 °C with short melting range. After interesterification, plasticity of products increased, which were comparable with commercial bakery fat. Some of the blends alone showed short melting profile like cocoa butter. Interesterification produced significant alteration in the triacylglycerol composition of the blends studied. Blends and the interesterified products prepared showed favorable characteristics with no transfats and hence could be used in the place of commercial bakery and confectionary fats.
Integrated DNA methylation and gene expression analysis identified S100A8 and S100A9 in the pathogenesis of obesity
Authors: Chen Ningyuan , Miao Liu , Lin Wei , Zhou Dong-Hua , Huang Ling , Huang Jia , Shi Wan-Xin , Li Li-Lin , Luo Yu-Xing , Liang Hao , Pan Shang-Ling , Peng Jun-Hua
Published: November 2020

Background: To explore the association of DNA methylation and gene expression in the pathology of obesity.Methods: (1) Genomic DNA methylation and mRNA expression profile of visceral adipose tissue (VAT) were performed in a comprehensive database of gene expression in obese and normal subjects; (2) functional enrichment analysis and construction of differential methylation gene regulatory network were performed; (3) Validation of the two different methylation sites and corresponding gene expression was done in a separate microarray data set; and (4) correlation analysis was performed on DNA methylation and mRNA expression data.Results: A total of 77 differentially expressed mRNA matched with differentially methylated genes. Analysis revealed two different methylation sites corresponding to two unique genes-s100a8-cg09174555 and s100a9-cg03165378. Through the verification test of two interested different expression positions (DMPS) and their corresponding gene expression, we found that the methylation in these genes was negatively correlated to gene expression in the obesity group. Higher S100A8 and S100A9 expression in obese subjects were validated in a separate microarray data set.Conclusion: This study confirmed the relationship between DNA methylation and gene expression and emphasized the important role of S100A8 and S100A9 in the pathogenesis of obesity.
Helical Coherent Structures in the Wake of Solitary Internal Waves Breaking on the Continental Slope
Authors: Soloviev Alexander , Vanderplow Breanna , Dean Cayla
Published: November 2020

Mixing caused by the solitary internal waves or solitons in stratified coastal waters is a primary cause of sediment resuspension and transport. Theoretical, experimental, and modeling studies of solitons have focused on nonlinear wave dynamics to explain their main features. However, the 3D cascade of energy from breaking internal wave solitons to turbulence and mixing in the wave induced wake has received less attention. Observations on the California shelf with a spatially distributed fiber optic sensing system revealed coherent structures in the wake of solitary internal waves breaking on the continental slope1,2. Here, we reproduced this phenomenon with a computational fluid dynamics model. The model demonstrated that the coherent structures in the wake of the breaking solitary internal wave are counterrotating helices. The concept of helicity3 as a topological invariant and a measure of the lack of mirror symmetry of the flow can explain the helical nature of these coherent structures4. Both observational and modeling results are consistent with this theoretical conjecture. These coherent structures have a substantial effect on the sediment transport in the bottom boundary layer, formation of nepheloid layers5, and nutrient fluxes.
Comparison of the Prediction of Winter Wheat Leaf Water Content by Using New Hyperspectral Index and Machine Learning Models
Authors: Zhang Juanjuan , Zhang Wen , Xiong Shuping , Song Zhaoxiang , Tian Wenzhong , Shi Lei , Ma Xinming
Published: November 2020

In this study, hyperspectral technology was used to establish the winter wheat leaf water content inversion model to provide technical reference for winter wheat precision irrigation. In a field experiment, seven different wheat varieties for different irrigation times were treated during two consecutive years. The data onto canopy spectral reflectance and leaf water content (LWC) of winter wheat were collected. Five different modeling methods, Spectral index, partial least squares (PLSR), random forest (RF), extreme random tree (ERT) and k-nearest neighbor (KNN) were used to construct LWC estimation models. The results showed that the canopy spectral reflectance was directly proportional to the irrigation times, especially in the near infrared band. As for LWC, the prediction effect of the newly differential spectral index DVI (R1185, R1308) is better than the existing spectral index, and R2 are 0.78. Because of the large amount of hyperspectral data. The correlation coefficient method (CA) and loading weight (x-Lw) are used to select the water characteristic bands from the full band. The results show that the accuracy of the model based on the characteristic band is not significantly lower than that of the full band. Among these models, the ERT- x-Lw model performs best (R2 and RMSE of 0.88 and 1.81; 0.84 and 1.62 for calibration and validation, respectively). In addition, the accuracy of LWC estimation model constructed by ERT-x-Lw was better than that of DVI (R1185, R1307). The results provide technical reference and basis for crop water monitoring and diagnosis under similar production conditions.
WITHDRAWN: The hidden diversity of diatrypaceous fungi in China; introducing Allodiatrypella gen. nov. and ten new species
Authors: Zhu Haiyan , Wijayawardene Nalin N. , Ma Rong , You Chongjuan , Dai Dongqin , Huang Manrong , Tian Chengming , Fan Xinlei
Published: November 2020

In this study, we investigated the diversity of diatrypaceous fungi from six regions in China based on morpho-molecular analyses (maximum parsimony, maximum likelihood and Bayesian inference analyses of combined ITS and tub2 gene regions). We accept 24 genera in Diatrypaceae with 19 genera involved in the phylogram and the other five genera are lacking living materials with available sequences. Eleven species include in four genera (viz. Allocryptovalsa, Diatrype, Eutypella and Allodiatrypella gen. nov.) have been isolated from seven hosts species, of which ten novel species (Allocryptovalsa castanea, Allodiatrypella betulae, A. betulicola, A. betulina, A. hubeiensis, A. xinjiangensis, Diatrype betulae, D. castaneicola, D. quercicola and Eutypella castaneicola) are introduced in this study, while Eutypella citricola is a new record from Morus host. Current results show the high diversity of members of Diatrypaceae species which are wood-inhabiting fungi in China.
Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals
Authors: Ssekatawa Kenneth , Byarugaba Denis K. , Nakavuma Jesca L. , Kato Charles D. , Ejobi Francis , Tweyongyere Robert , Wampande Eddie M.
Published: November 2020

Background: Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections. The K. pneumoniae infections have considerably contributed to morbidity and mortality in patients with protracted ailments. The capacity of K. pneumonia to cause diseases depends on presence of an array virulent factors. Coexistence and expression of virulent factors and genetic determinants of antibiotic resistance complicates treatment outcomes. Thus, emergence of pathogenic MDR K. pneumoniae poses a great threat to the healthcare system. However, the carriage of antibiotic resistance among pathogenic K. pneumoniae is yet to be investigated in Uganda. We sought to investigate the carbapenem resistance profiles and pathogenic potential based on capsular serotypes of K. pneumoniae clinical isolates. Methods: This was a cross sectional study involving use of archived Klebsiella pneumoniae isolates collected between January and December, 2019 at four tertiary hospitals in Uganda. All isolates were subject to antimicrobial susceptibility assays to determine phenotypic antibiotic resistance, pentaplex PCR to detect carbapenemases encoding genes and heptaplex PCR to identify capsular serotypes K1, K2, K3, K5, K20, K54 and K57.Results: The study found an overall phenotypic carbapenem resistance of 23.3% (53/227) and significantly higher genotypic resistance prevalence of 43.1% (98/227). Over all, the most prevalent gene was blaOXA-48-like (36.4%), followed by blaIMP-type (19.4%), blaVIM-type (17.1), blaKP-type (14.0%) and blaNDM-type (13.2%). blaVIM-type and blaOXA-48-like conferred phenotypic resistance in all isolates and 38.3% isolates that harbored them respectively. Capsular multiplex PCR revealed that 46.7% (106/227) isolates were pathogenic and the predominantly prevalent pathotype was K5 (18.5%) followed by K20 (14.1%), K3 (7.1%), K2 (3.1%) and K1 (2.2%). Of the 106 capsular serotypes, 37 expressed phenotypic resistance; thus, 37 of the 53 carbapenem resistant K. pneumoniae were pathogenic.Conclusion: The high prevalence of virulent and antibiotic resistant K. pneumoniae among clinical isolates obtained from the four tertiary hospital as revealed by this study pose a great threat to healthcare. Our findings underline the epidemiological and public health risks and implications of this pathogen.